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Biomedical subjects

C Silfverswärd

Publications and source records attributed to C Silfverswärd.

At least 55 records · Page 3Linked to original sources
PubMed1989

Mortality in a cohort of radiation treated childhood skin hemangiomas.

Mortality was studied in 18,357 patients (33% males and 67% females) with skin hemangioma admitted to Radiumhemmet between 1920 and 1959. The treatments of the hemangiomas were performed by radium-226 sources (13,094 patients) or x-ray therapy (2,540 patients). In 2,723 patients no radiotherapy was given. The median age was 6 months for the treated patients and 8 months for the patients not receiving radiotherapy. Between 1920 and 1951 a total of 154 patients were reported dead. The cohort was matched with the Swedish Cause of Death Register between 1952 and 1985. During that period 504 died, in 146 patients the cause of death was cancer or leukemia. The total number of person-years at risk was 587,426. In patients treated with radium-226 or orthovoltage x-rays, 410 deaths occurred (standardized mortality ratio (SMR) = 1.07; ns). In patients given contact therapy 34 deaths occurred (SMR = 0.82; ns) and in the not irradiated group 60 deaths occurred (SMR = 0.78; ns). Patients treated with radium-226 or orthovoltage x-rays had an SMR of 1.34 for all cancers combined (p less than 0.05). For patients treated between 1920 and 1939 the SMR for cancer was 1.53 (p less than 0.05) as compared to an SMR of 1.16 (ns) for those treated between 1940 and 1959.

Adolescent↗
PubMed1989

Prognostication including DNA analysis in osteosarcoma.

In a retrospective study of 83 osteosarcoma patients treated by surgery and adjuvant interferon from 1971 to 1986, the clinical course was related to different clinicopathologic features and tumor DNA content. DNA analysis was feasible in 60 cases. Four tumors were diploid and 56 hyperploid. The 7-year survival rate, estimated by life-table analysis, was 0.44 for the whole series. Multivariate analysis disclosed that male sex, proximal tumor location, and histologic Grade IV were independent risk factors--all approximately of equal strength. DNA analysis did not provide prognostic information, except for tumors with extreme abnormality of the DNA content, which was associated with a very poor prognosis. A prognostication model was created, based on the number of risk factors present. The 7-year survival rate for patients with none, one, two, or three risk factors was 0.80, 0.59, 0.42, and 0.13, respectively. The estimated 7-year rate of local recurrence was 0.29: 0.07 after ablative surgery and 0.54 after local surgery. Among patients who were free of metastasis 1 year after diagnosis, local recurrence reduced the 7-year survival rate from 0.86 to 0.48. In high-grade osteosarcoma, conventional clinicopathologic features and local tumor control remain the most important prognostic factors.

Adolescent↗
PubMed1989

Ploidy and morphology in osteosarcoma.

In a cytometric DNA study of high-grade osteosarcoma, the relationship between DNA content and morphology was analyzed. The investigation, based on microspectrophotometry of tissue sections and flow cytometry (FCM), included both primary lesions and recurrences. FCM analysis, applied to a consecutive series of 47 primary osteosarcomas, disclosed that 2 were diploid and 45 were nondiploid, 8 of which were tetraploid. Multiple aneuploid peaks were detected in 13 tumors. Among the nondiploid tumors, there was no clear relationship between the peak DNA value(s) and the histologic subtype (osteoblastic, chondroblastic, fibroblastic) or grade (III-IV). The proliferative activity, as reflected by the percentage of S-phase cells, could be determined in 38 of the 47 tumors analyzed by FCM. The percentage was higher for aneuploid than for tetraploid lesions; however, the distribution of S-phase cells was not related to the histologic subtype or the grade of the tumors. To assess the reliability of a single sample for FCM, the DNA content of biopsy and surgical specimens was compared in 20 tumors; there was complete agreement in all cases with respect to the classification of the lesion as diploid, tetraploid or aneuploid. Analysis by FCM or microspectrophotometry of 12 local recurrences and 16 metastases and the corresponding 19 primary tumors showed that an aneuploid characteristic of the primary lesion was retained during progression of the disease. In 12 tumors analyzed by microspectrophotometry in tissue sections, comparison of chondroblastic and osteoblastic/fibroblastic areas within the same lesion consistently disclosed hyperploidy in both areas.(ABSTRACT TRUNCATED AT 250 WORDS)

DNA, Neoplasm↗
PubMed1988

Cancer incidence after radiotherapy for skin hemangioma: a retrospective cohort study in Sweden.

The cancer incidence was studied in 18,030 patients (33% males, 67% females) with skin hemangioma who were admitted to Radiumhemmet, Karolinska Hospital, Stockholm, Sweden, 1920-1959. Radium-226 sources were used in 12,821 patients, x-ray therapy was used in 2,515 patients, and no radiotherapy was given to 2,694 patients. Cancer incidence in the cohort was searched by record linkage with the Swedish Cancer Register for the period 1958-1982. The median age was 6 months for the treated patients and 8 months for the patients not receiving radiotherapy. In the group treated with radium-226 or orthovoltage x rays (greater than or equal to 100-kV peak), 224 cancers were observed [relative risk (RR) = 1.18; 95% confidence interval (CI) = 1.03-1.35]. In patients given contact x rays, 10 cancers were observed (RR = 0.71; 95% CI = 0.34-1.30). In patients not treated with ionizing radiation, 34 cancers were observed (RR = 0.93; 95% CI = 0.64-1.29). In patients treated with radium-226 or orthovoltage x rays, an RR of 1.65 was observed for breast cancer (95% CI = 1.26-2.13) and an RR of 2.73 was found for soft tissue tumors (95% CI = 1.18-5.38). Patients with brain tumors, thyroid cancers, and bone tumors had received radiotherapy close to the tumor site more often than expected. For patients with breast cancer, no such difference was found. For cancers of the breast and thyroid, the RR was higher in patients given more than one treatment.

Adult↗
PubMed1988

DNA analysis in the differential diagnosis of osteosarcoma.

The DNA content of osteosarcomas, and of giant cell tumors, osteoblastomas, aneurysmal bone cysts, and fibrous dysplasias was determined by cytophotometry. Of 158 tumors, 141 were histologically noncontroversial, whereas 17 posed diagnostic difficulties. In the noncontroversial group, all 41 benign tumors had a diploid (normal) DNA content. Ninety-two of 96 high-grade osteosarcomas were hyperploid (increased DNA content). The four analyzed low-grade parosteal osteosarcomas were diploid. Among 17 diagnostically controversial cases, nine were primarily diagnosed and treated as benign. Three of these patients, nevertheless, exhibited a malignant clinical course and two had local recurrence. All five proved to have hyperploid tumors. The four nonrecurrent lesions were diploid. Of eight patients primarily evaluated as malignant, one died and two developed local recurrence. These three patients had hyperploid tumors. Among the five nonrecurrent lesions, two were hyperploid and three diploid. In the diagnostically controversial group, recurrence or death was consistently related to hyperploidy. The present study shows that the vast majority of high-grade osteosarcomas are hyperploid. Benign bone tumors, which may be mixed up histologically with osteosarcoma, are diploid. Routine DNA analysis of primary bone tumors, as an adjunct to histopathologic assessment, can be employed to obtain diagnostic confirmation. In cases presenting histopathologic difficulties, ploidy determination may provide decisive diagnostic information.

Adolescent↗
PubMed1988

DNA analysis in the differential diagnosis of osteosarcoma.

The DNA content of osteosarcomas, and of giant cell tumors, osteoblastomas, aneurysmal bone cysts, and fibrous dysplasias was determined by cytophotometry. Out of 158 tumors, 141 were histologically noncontroversial, whereas 17 posed diagnostic difficulties. In the noncontroversial group all 41 benign tumors had a diploid (normal) DNA content. Ninety-two of 96 high-grade osteosarcomas were hyperploid (increased DNA content). The four analyzed low-grade parosteal osteosarcomas were diploid. Among 17 diagnostically controversial cases, nine were primarily diagnosed and treated as benign. Three of these patients, nevertheless, exhibited a malignant clinical course and two had local recurrence. All five proved to have hyperploid tumors. The four nonrecurrent lesions were diploid. Of eight cases primarily evaluated as malignant, one died and two developed local recurrence. These three patients had hyperploid tumors. Among the five nonrecurrent lesions, two were hyperploid and three diploid. Hence, in the diagnostically controversial group, recurrence or death was consistently related to hyperploidy. The current study shows that the vast majority of high-grade osteosarcomas are hyperploid. Benign bone tumors, which may be mixed up histologically with osteosarcoma, are diploid. Routine DNA analysis of primary bone tumors, as an adjunct to histopathologic assessment, can be employed to obtain diagnostic confirmation. In cases presenting histopathologic difficulties, ploidy determination may provide decisive diagnostic information.

Adolescent↗
PubMed1988

Origin of the choanal polyp.

To study the origin of the choanal polyp, the maxillary sinus was surgically explored using a preservative technique. An antral cyst or a cystic rudiment, usually attached to the inferolateral aspect of the sinus wall, was disclosed in 15 patients with this condition. As a part of the choanal polyp, the antral cyst exhibited a macroarchitecture and microarchitecture identical to the structure of the common intramural cyst of the maxillary sinus as studied in nine patients. It is concluded that the choanal polyp develops from the expanding intramural cyst protruding through the maxillary ostium and into the nasal cavity.

Adult↗
PubMed1986

Thyroid carcinoma in children and adolescents.

Forty patients aged 20 years or younger at the time of the diagnosis of thyroid carcinoma were followed between 10 and 35 years (mean, 22 years). All patients had had surgery, either a total thyroidectomy or a resection. Sixteen patients received additional radiotherapy. One patient died during surgery. Two patients died of metastatic tumor growth, 5 and 14 years after the primary diagnosis, respectively. Six further patients had recurrences (1-7.5 years after first treatment) and received further treatment. At the end of the study 37 patients were alive without signs of recurrence.

Adolescent↗
PubMed1986

Adenocarcinoma of the uterine cervix.

Between 1958 and 1969, 251 patients were treated at Radiumhemmet in Stockholm for adenocarcinoma of the uterine cervix. The histologic specimens were reevaluated. In the 211 cases of pure adenocarcinoma, the 5-year survival rate was compared with that in the total of cervical epithelial malignancies. The rate was lower in the adenocarcinoma cases, with respective crude 5-year survival rates of 84%, 50%, and 9% in Stages I, II, and III. Two modes of treatment, irradiation alone or irradiation plus radical surgery, were used in Stages IB and IIA. The combined treatment gave significantly improved 5-year survival rates.

Adenocarcinoma↗
PubMed1986

Preoperative diagnosis of renal oncocytoma and treatment possibilities.

We report 2 cases of renal oncocytoma and review the literature. A number of radiological, cytological and ultrastructural differential features of oncocytoma that are known today make preoperative diagnosis of this tumour possible. Analysis of the reported cases allows to conclude that oncocytomas are of universally benign character with a very good prognosis. Metastases have not been documented. Thus we suggest that many patients with oncocytoma could be spared the operation of nephrectomy. Partial kidney resection or heminephrectomy are to be preferred with solitary oncocytomas of a moderate size.

Adenoma↗
PubMed1986

Radiation therapy in operable breast cancer: results from the Stockholm trial on adjuvant radiotherapy.

In a randomized trial, 960 women with Stage 1-3 operable breast cancer were treated by a modified radical mastectomy alone, or by the same procedure, preceded or followed by radiotherapy (4500 rad to the breast/chest wall, and internal mammary, axillary and supraclavicular lymph nodes). Up to ten years after treatment, there is an increasing gap between the recurrence-free survival of the irradiated patients and the surgical controls. Between the two types of radiotherapy, there was no difference. There were significantly fewer distant metastases and a tendency for improved survival in node positive patients treated with postoperative radiotherapy, compared to the surgical controls, this difference was, however, statistically not significant.

Aged↗
PubMed1986

Ovarian cancer: the challenge of local tumor control and its impact on survival.

To achieve better understanding of the factors influencing local control of ovarian cancer, an analysis of failure in early stages of ovarian carcinoma has been carried out. The material consisted of 185 patients diagnosed in early stages; 40 of them failed in their disease, 17 with local recurrence, 23 with distant metastases. The material was analyzed with respect to age, histology, grade, size and surface of the tumor, the surgical procedure and treatment modalities, and the time between treatment and recurrence, and recurrence and death. In the analysis, both the behavior of the ovarian cancer tumor and the pattern of failure was shown to be different for each histological group.

Combined Modality Therapy↗
PubMed1986

Comparison between histologic type, estrogen receptor, and nuclear DNA content in mammary carcinoma.

Histological specimens from 80 invasive breast carcinomas comprising typical cases of 16 ductal, nine papillary, 14 comedo, 13 colloid (mucous), 15 lobular, and 13 medullary carcinomas were examined with respect to nuclear DNA and estrogen receptor content. In agreement with previous studies, ductal carcinomas were found to exhibit different types of nuclear DNA distribution patterns, i.e., tumors with DNA values in the normal diploid or tetraploid regions indicative of good prognosis (euploid tumors) or those with values exceeding the normal tetraploid region indicative of poor prognosis (aneuploid tumors). The majority of the papillary and colloid tumors were euploid, while comedocarcinomas in general had aneuploid profiles. These findings are in agreement with expected survival within these patient groups. In lobular breast carcinomas, the correlation between the DNA distribution patterns and expected patient survival was less obvious; and in medullary carcinomas where the vast majority of the tumors showed aneuploid DNA profiles, the correlation to expected patient survival was low. Thus, lobular carcinoma in general seems to have a worse prognosis than is expected from nuclear DNA analysis, whereas medullary carcinomas in general seem to carry a better prognosis than indicated from DNA measurements. In agreement with earlier reports there was a good correlation between nuclear DNA content of the tumor cells and cytosol estrogen receptor values, i.e., euploid tumors in general exhibited relatively high receptor levels, whereas aneuploid tumors had low or unmeasurable estrogen receptor levels.

Breast Neoplasms↗
PubMed1986

Prognostic significance of nuclear DNA analysis in histological sections in mammary carcinoma.

The nuclear DNA content in tumor cells from invasive ductal breast carcinomas was analyzed in 26 patients who survived more than 10 years and in 23 patients who died within 2 years after operation. The DNA content of individual tumor cells was measured in sections from the originally paraffin-embedded specimens. In short-term survivors, a large proportion of cells with very high DNA values was found in all tumors except one. Only two patients of the long-term survivors had tumors that exhibited such high DNA values. Prognostic information obtained by DNA analysis compared with histologic malignancy grading showed that the specificity using DNA analysis was distinctly higher. The data thus suggest that analysis of DNA content of tumor cells in breast adenocarcinomas can be a useful supplement to histologic malignancy grading to obtain prognostic guidance in individual patients.

Adenocarcinoma↗