Biomedical subjects

Henrik Møller

Publications and source records attributed to Henrik Møller.

7 recordsLinked to original sources

PubMed2004

Breast carcinoma survival in Europe and the United States.

BACKGROUND: Breast carcinoma survival rates were found to be higher in the U.S. than in Europe. METHODS: Multiple regression analysis of breast carcinoma survival rates among women diagnosed between 1990 and 1992 was performed using clinical data from population-based case series from the Surveillance, Epidemiogy, and End Results (SEER) program (13,172 women) and the European Concerted Action on survival and Care of Cancer Patients (EUROCARE) project (4478 women). RESULTS: Early-stage tumors (T1N0M0) were more frequent in the SEER data (41% of cases) than in the EUROCARE data (29%). In the SEER data, early tumors were more frequent in women age > or = 65 years (43%) than in younger women (38%), whereas the reverse was true in the European data (25% vs. 31%). In both case series, > 90% of women underwent surgery and 81-82% underwent lymphadenectomy, but the number of axillary lymph nodes evaluated was higher in the SEER data than in the EUROCARE data. The 5-year survival rate was higher in the U.S. case series (89%) than in the European series (79%). This differential was observed for each stage category evaluated: early (T1N0M0), large lymph node-negative (T2-3N0M0), lymph node-positive (T1-3N+M0), locally advanced (T4M0), and metastatic (M1) tumors. The overall relative excess risk (RER) of death was significantly higher (RER, 1.37; 95% confidence interval [95% CI], 1.25-1.50) among European women compared with U.S. women (referent group). Adjustment for stage, age, surgery, and the number of lymph nodes evaluated explained most of the excess risk (RER, 1.07; 95% CI, 0.98-1.17). CONCLUSIONS: Transatlantic differences in the 5-year survival rates for women diagnosed with breast carcinoma between 1990 and 1992 were attributable mainly to differences in stage of disease. Resources should be invested to achieve earlier diagnosis of breast carcinoma in Europe, especially for elderly women.

Adult↗

PubMed2003

[Tonsillectomy a chaud with lethal outcome].

The case describes a 21-year-old patient who was referred to the casualty ward due to post tonsillectomy haemorrhage. The patient who had been operated for a peritonsillar abscess eight days earlier, died in spite of optimal treatment.

Adult↗

PubMed2003

Salvage laryngectomy and pharyngocutaneous fistulae after primary radiotherapy for head and neck cancer: a national survey from DAHANCA.

OBJECTIVE: In 1998, the Danish Society for Head and Neck Oncology decided to conduct a nationwide survey at the five head and neck oncology centers with the aim of evaluating the surgical outcome of salvage laryngectomy after radiotherapy with special emphasis on identifying factors that could contribute to the development of pharyngocutaneous fistulae. PATIENTS: A total of 472 consecutive patients undergoing postirradiation salvage laryngectomy in the period July 1, 1987-June 30, 1997 were recorded at the five head and neck oncology centers in Denmark. Age ranged from 36 to 84 years, median 63 years, 405 men and 67 women. Primary tumor site was glottic larynx (n = 242), supraglottic larynx (n = 149), other larynx (n = 45), pharynx (n = 27), and other (n = 9). All patients had received prior radiotherapy. RESULTS: Median time between radiotherapy and laryngectomy was 10 months (range, 1-348 months). A total of 89 fistulae lasting at least 2 weeks were observed, corresponding to an overall average fistulae risk of 19%. The number of performed laryngectomies per year decreased linearly (from 58 to 37), whereas the annual number of fistulae increased slightly (from 7 to 11), which meant that the corresponding estimated fistulae risk increased significantly from 12% in 1987 to 30% in 1997. Other significant risk factors for fistulae in univariate analysis included younger patient age, primary advanced T and N stage, nonglottic primary site, resection of hyoid bone, high total radiation dose, and large radiation fields. Multiple logistic regression analysis of these parameters suggested that nonglottic tumor site, late laryngectomy period (1987-1992 vs 1993-1997), and advanced initial T stage were independent prognostic factors for fistulae risk. Surgical parameters like resection of thyroid/tongue base/trachea or radiotherapy parameters like overall treatment time or fractions per week did not influence fistulae risk. CONCLUSIONS: The risk of fistulae is especially high in patients initially treated with radiotherapy for nonglottic advanced stage tumors. A significant decrease in the number of performed salvage laryngectomies over the 10 years was seen. Over the same time period, the annual number of fistulae remained almost constant. The resulting more than doubling of fistulae rate could thus in part be explained by less surgical routine.

Adult↗

PubMed2003

Recent trends in prostate cancer incidence and mortality in southeast England.

OBJECTIVE: To investigate recent trends in prostate cancer incidence and mortality, with particular reference to changes in diagnostic techniques and treatment. METHODS: The Thames Cancer Registry was used to identify all men, resident in SE England, diagnosed with prostate cancer between 1990 and 1999. Information regarding prostate cancer mortality was obtained from the Office of National Statistics. Other data sources were used to ascertain the number of transurethral resections of the prostate (TURP) and open prostatectomies performed in SE England, and the number of prescriptions issued for the treatment of benign prostatic hyperplasia (BPH). RESULTS: There was a steady increase in the age-standardised incidence of prostate cancer from 1990, which then began to plateau in 1996. The increase was entirely restricted to localised tumours; non-localised tumours showed a slight downward trend over this period. Age-standardised mortality rates have remained constant, with a slight fall in 1997 corresponding to the decline in incidence rates. Medical treatment for BPH has increased, with a corresponding reduction in the number of TURPs. CONCLUSION: The change in occurrence of prostate cancer is entirely due to changes in the incidence of localised cases. Incidence of non-localised cases and mortality remained almost constant. The increasing tendency in incidence of localised prostate cancer is likely to be principally due to increased detection, through increased use of prostate-specific antigen (PSA) testing followed by radical resections of the prostate. The aggregate effect of PSA testing and medical treatment of BPH is a stabilisation in the incidence level of localised cases in recent years.

Adenocarcinoma↗

PubMed2003

Epidemiology of gonadal germ cell cancer in males and females.

The epidemiology of testicular germ cell cancer is relatively well understood, but less is known about the epidemiology of ovarian germ cell cancer. Cases of testicular (7910) and ovarian (453) germ cell cancer diagnosed 1960-1999 were extracted from the Thames Cancer Registry. The incidence rate in males doubled in the period from 2.0 to 4.4 per 100,000. In females the rate was much lower but the rate of increase over the period was similar to the increase in males. In both sexes the incidence increased sharply around the age of onset of puberty and decreased in older age groups. The biological mechanism of initiation of germ cell carcinogenesis is similar in males and females and probably occurs with roughly the same frequency in the two sexes. In males, the initiated cell population is promoted by the normal action of adult sex hormones to form carcinoma in situ, consisting of many millions of cells. The incidence of testicular cancer is rate limited by the development of carcinoma in situ. The key difference between males and females, which may explain the different levels of incidence, is the much lower number of susceptible cells in females at the time of puberty.

Adolescent↗

PubMed2002

Comparison of a specialist haematological malignancy database against a regional cancer registry: case ascertainment and diagnostic accuracy.

No large-scale study has been performed to assess the problem of registering all subtypes of haematological malignancies. We compared registration of haematological malignancies between 1994 and 1996 by haematologists in 14 National Health Service Trusts in the Eastern part of the South Thames Region with data for the same area recorded by the Thames Cancer Registry (TCR). Case ascertainment and diagnostic accuracy were the two main outcome measures. A combined total of 4714 haematological malignancies were recorded over the 3-year period. Of these, 1329 (28%) were common to both databases, 1975 (42%) were recorded only by the TCR and 1410 (30%) were recorded only by the haematologists. Nearly one-third (31%) of all cases recorded by the TCR were death certificate-only registrations. The TCR records were obtained from 30 clinical specialities. Haematology only accounted for 35% of these cases. Discordant diagnoses were recorded in 20% of the cases that were recorded in both databases. Our data suggests that both registers have deficiencies in collecting and validating data on the incidence of haematological malignancies. To address this, a partnership was established in 1998 between haematologists in the South Thames Region and the Thames Cancer Registry. It is anticipated that engaging clinicians in the collection and validation of data will enhance the completeness of case ascertainment and improve the quality of data on haematological malignancies.

Adolescent↗

PubMed2002

Mortality in relation to early retirement in Denmark: a population-based study.

AIMS: The aim of this study was to examine whether early retirement is gained by persons with poor health or whether retirement leads to negative changes in health. Mortality for persons in Denmark using one of two publicly financed retirement schemes was investigated. Disability benefit (førtidspension) was granted for health reasons mainly, while early retirement benefit (efterløn) was earned through long-term membership of an unemployment benefit scheme. METHODS: Data from Danish population-based registers were used for each year in the period 1986-96. The study setting was the population of Denmark, born between 1926 and 1936. RESULTS: the standardized mortality ratio in employed persons was low (0.59 and 0.51 for men and women, respectively) and high in disability benefit recipients (2.31 and 1.66). The mortality in the early retirement benefit recipients (0.88 and 0.72) was in between the mortality for the disability benefit recipients and the employed persons. Disability benefit recipients had a high relative risk of death immediately after retirement. In early retirement recipients the relative risk of death increased with time since retirement. CONCLUSIONS: Disability benefit was mainly gained by persons with poor health. In contrast, the increasing mortality of the early retirement recipients is consistent with an adverse effect on health of retirement itself, but may also be due to the cessation of health selection in the group of disability benefit recipients after retirement. It is difficult to disentangle the effects of a change in activity following retirement from the effects of an earlier health-associated selection into the two retirement schemes.

Aged↗