Tamoxifen-related uterine carcinosarcomas occur under/after prolonged treatment: Report of five cases and review of the literature

2002 ◽  
Vol 12 (5) ◽  
pp. 496-500 ◽  
Author(s):  
I. Kloos ◽  
S. Delaloge ◽  
P. Pautier ◽  
M. Di Palma ◽  
A. Goupil ◽  
...  
Keyword(s):  
Prolonged Exposure ◽  
Endometrial Adenocarcinoma ◽  
Latency Period ◽  
Subsequent Development ◽  
Prolonged Treatment ◽  
Uterine Carcinosarcoma ◽  
Long Latency ◽  
Daily Dose

The risk of tamoxifen-related endometrial adenocarcinoma is well established with daily dose and treatment duration of adjuvant tamoxifen as risk factors. There have also been in the past years, a few descriptions of uterine nonepithelial malignancies occuring after tamoxifen. We describe five recent cases of uterine carcinosarcomas occurring under/after tamoxifen administered in an adjuvant setting. None of these patients had received prior pelvic radiation therapy. Their median age at the diagnosis of breast cancer was 58 years (41–68), and 69 years (50–84) at the diagnosis of uterine carcinosarcoma. The median length of exposure to tamoxifen was 9 years (5–20), and the median time from the initiation of tamoxifen to the diagnosis of the uterine malignancy (latency period) 9 years (7–20). All patients presented with an advanced stage (IIA-IVA). Our data, together with those of the literature, plead for a causal role of a prolonged exposure to tamoxifen on the subsequent development of uterine carcinosarcoma. The long latency period observed even in patients receiving only 5 years of treatment leads us also to consider a prolonged gynecologic follow-up of the patients.

“Re-Emergence” of Silicosis and Coal Workers Pneumoconiosis in Australia

2020 ◽  
Vol 119 (1) ◽  
pp. 65-92
Author(s):  
Beris Penrose
Keyword(s):  
Data Collection ◽  
Coal Mining ◽  
Disease Onset ◽  
Latency Period ◽  
Dust Exposure ◽  
Long Latency ◽  
History Of ◽  
Coal Workers Pneumoconiosis ◽  
Coal Workers

Some reporters, politicians, and doctors have described current cases as a “re-emergence” of these diseases, based on the notion that they had been eliminated. However, silicosis persisted in centuries-old industries like sandblasting and stonemasonry and coal workers pneumoconiosis (CWP) continued in coal mining. Until recently, their presence was obscured by a combination of factors such as misdiagnosis, especially if there was a history of smoking; the failure to follow up workers thought to have silicosis or CWP; the long latency period between dust exposure and disease onset that can conceal the link between the two; and the lack of data collection that may have revealed their presence. As the recent Queensland government inquiry into CWP noted, current cases are more accurately a reidentification.

scholarly journals Role of biomarkers in predicting the occurrence of thyroid neoplasms in radiation-exposed children

2018 ◽  
Vol 25 (4) ◽  
pp. 481-491
Author(s):  
Joseph M Shulan ◽  
Leonid Vydro ◽  
Arthur B Schneider ◽  
Dan V Mihailescu
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Subsequent Development ◽  
Thyroid Neoplasms ◽  
Childhood Cancer Survivors ◽  
Malignant Neoplasms ◽  
Increased Risk ◽  
Need To Evaluate

With increasing numbers of childhood cancer survivors who were treated with radiation, there is a need to evaluate potential biomarkers that could signal an increased risk of developing thyroid cancer. We aimed to examine the relationships between thyrotropin and thyroglobulin levels and the risk of developing thyroid nodules and cancer in a cohort of radiation-exposed children. 764 subjects who were irradiated in the neck area as children were examined and followed for up to 25 years. All subjects underwent a clinical examination, measurements of thyrotropin, thyroglobulin levels and thyroid imaging. At baseline, 216 subjects had thyroid nodules and 548 did not. Of those with nodules, 176 underwent surgery with 55 confirmed thyroid cancers. During the follow-up, 147 subjects developed thyroid nodules including 22 with thyroid cancer. Thyroglobulin levels were higher in subjects with prevalent thyroid nodules (26.1 ng/mL vs 9.37 ng/mL; P < 0.001) and in those who had an initial normal examination but later developed thyroid nodules (11.2 ng/mL vs 8.87 ng/mL; P = 0.017). There was no relationship between baseline thyrotropin levels and the prevalent presence or absence of thyroid nodules, whether a prevalent neoplasm was benign or malignant, subsequent development of thyroid nodules during follow-up or whether an incident nodule was benign or malignant. In conclusion, in radiation-exposed children, higher thyroglobulin levels indicated an increased risk of developing thyroid nodules but did not differentiate between benign and malignant neoplasms. There was no association between the baseline TSH level and the risk of developing thyroid nodules or cancer.

Osteomeatal Complex Obstruction is not Associated with Adjacent Sinus Disease in Chronic Rhinosinusitis with Polyps

2011 ◽  
Vol 25 (6) ◽  
pp. 401-403 ◽  
Author(s):  
Randy M. Leung ◽  
Robert C. Kern ◽  
David B. Conley ◽  
Bruce K. Tan ◽  
Rakesh K. Chandra
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Disease Process ◽  
Subsequent Development ◽  
Ct Scans ◽  
Osteomeatal Complex ◽  
Maximal Medical Therapy ◽  
Previous Pilot Study

Background It is universally accepted that osteomeatal complex (OMC) disease is linked to the subsequent development of chronic rhinosinusitis without nasal polyps (CRSsNPs) via postobstructive mechanisms. The role of OMC obstruction in the pathogenesis of CRSwNPs is less clear. This study was designed to identify if there is an association between OMC obstruction and inflammation of the adjacent sinuses, when patients are stratified by polyp status. This is a follow-up and expanded series of a previous pilot study from our group. Method CT scans of 144 patients with CRSsNPs and 123 patients with CRS with nasal polyps (CRSwNPs) were evaluated for each sinus and OMC. Patients had no previous surgeries for NPs. CT scans were obtained after a trial of maximal medical therapy. Results Increasing OMC involvement was associated with increasing Lund-Mackay score for both CRSsNPs and CRSwNPs. In CRSsNP patients, OMC status significantly correlated with adjacent sinus status (p < 0.0001). Meanwhile in CRSwNPs, OMC status does not correlate with adjacent sinus status (p = 0.328). Conclusion OMC obstruction in the setting of CRSwNP may be a barometer of the overall disease process, but in this scenario, paranasal sinus inflammation can not be classified as a postobstructive phenomenon. These findings question the role of minimally invasive procedures in the management of CRSwNPs.

scholarly journals Blood Interferon Signatures Putatively Link Lack of Protection Conferred by the RTS,S Recombinant Malaria Vaccine to an Antigen-specific IgE Response

F1000Research ◽  
2017 ◽  
Vol 4 ◽  
pp. 919
Author(s):  
Darawan Rinchai ◽  
Scott Presnell ◽  
Marta Vidal ◽  
Sheetij Dutta ◽  
Virander Chauhan ◽  
...  
Keyword(s):  
Malaria Infection ◽  
Malaria Vaccine ◽  
Subsequent Development ◽  
Specific Ige ◽  
Post Vaccination ◽  
Mortality And Morbidity ◽  
Ige Response ◽  
Blood Transcriptome

Malaria remains a major cause of mortality and morbidity worldwide. Progress has been made in recent years with the development of vaccines that could pave the way towards protection of hundreds of millions of exposed individuals. Here we used a modular repertoire approach to re-analyze a publically available microarray blood transcriptome dataset monitoring the response to malaria vaccination. We report the seminal identification of interferon signatures in the blood of subjects on days 1, 3 and 14 following administration of the third dose of the RTS,S recombinant malaria vaccine. These signatures at day 1 correlate with protection, and at days 3 and 14 to susceptibility to subsequent challenge of study subjects with live parasites. In addition we putatively link the decreased abundance of interferon-inducible transcripts observed at days 3 and 14 post-vaccination with the elicitation of an antigen-specific IgE response in a subset of vaccine recipients that failed to be protected by the RTS,S vaccine. Furthermore, profiling of antigen-specific levels of IgE in a Mozambican cohort of malaria-exposed children vaccinated with RTS,S identified an association between elevated baseline IgE levels and subsequent development of naturally acquired malaria infection during follow up. Taken together these findings warrant further investigation of the role of antigen-specific IgE in conferring susceptibility to malaria infection.

scholarly journals Meta-Analysis of the Association between Asbestos Exposure and Esophageal Cancer

2021 ◽  
Vol 18 (21) ◽  
pp. 11088
Author(s):  
Chih-Wei Wu ◽  
Hung-Yi Chuang ◽  
Dong-Lin Tsai ◽  
Tzu-Yu Kuo ◽  
Chen-Cheng Yang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Subgroup Analysis ◽  
Textile Industry ◽  
Meta Analysis ◽  
Asbestos Exposure ◽  
Latency Period ◽  
High Dose ◽  
Long Latency ◽  
Standardized Mortality Rate

Background: We conducted a meta-analysis to quantitatively assess the association between asbestos exposure and esophageal cancer. Methods: We systematically collected articles from three electronic databases and calculated the pooled standardized mortality rate (SMR) from the meta-analysis. Subgroup analysis according to the type of asbestos exposure, follow-up years, sample size, industry classification, sex, and high-dose exposure was conducted. Results: From 242 studies, 34 cohort studies were included in our meta-analysis. Pooled SMR was positively associated with asbestos exposure and esophageal cancer (pooled SMR = 1.28; 95% confidence interval (CI) 1.19–1.38, p < 0.00001). In the subgroup analysis, (1) chrysolite, (2) four groups with follow-up over ten years, (3) the textile industry and shipyard, (4) both male and female, and (5) eight studies on highest asbestos exposure, all the subgroups showed significantly increased pooled SMRs. Conclusion: Asbestos exposure was significantly and positively associated with esophageal cancer, especially chrysolite. Considering the long latency period, we suggest that patients should be followed up for cancer, including esophageal cancer, for over ten years.

Upper tract transitional cell carcinoma following or related to bladder cancer: Controversies

1996 ◽  
Vol 63 (1) ◽  
pp. 25-28
Author(s):  
S. Cosciani Cunico ◽  
E. Frego ◽  
M. Scanzi ◽  
T. Zanotelli ◽  
E. Panizza ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Tract ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Vesicoureteral Reflux ◽  
Transitional Cell ◽  
Latency Period ◽  
Upper Urinary Tract

— The incidence of upper urinary tract transitional cell carcinoma (UTTCC) following a bladder cancer has been studied in 1731 urothelial tumours from 1984 to 1995. The UTTCC were 88: 59 primitive, 6 synchronous and 23 metachronous after a bladder cancer (1672). Of the 23 metachronous UTTCC, 17 followed TURBT (17/1310 = 1.3%): the latency period was very long (64.8 months); grading and staging were mostly similar to the foregoing bladder tumours. A vesicoureteral reflux raised the metachronous UTTCC rate to 17.6%. A neoplastic distal ureter was found during radical cystectomy in 2.24%. During the follow-up of 362 radical cystectomies 6 (1.65%) metachronous UTTCC were recorded. A metachronous UTTCC is always a poor prognostic sign. There are some controversies concerning this topic such as: the role of IVP and urine cytology in the follow-up of bladder cancer, the management of a vesicoureteral reflux in bladder cancer and the choice of a urinary diversion in the event of an upper urinary tract at high risk for UTTCC.

Long-Term Follow-Up of Patients With Follicular Lymphoma Receiving Single-Agent Rituximab at Two Different Schedules in Trial SAKK 35/98

2010 ◽  
Vol 28 (29) ◽  
pp. 4480-4484 ◽  
Author(s):  
Giovanni Martinelli ◽  
Shu-Fang Hsu Schmitz ◽  
Urs Utiger ◽  
Thomas Cerny ◽  
Urs Hess ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Prolonged Exposure ◽  
Cox Regression ◽  
Single Agent ◽  
Long Term Results ◽  
Prolonged Treatment ◽  
Long Term Follow Up ◽  
Favorable Prognostic Factor

Purpose We report the long-term results of a randomized clinical trial comparing induction therapy with once per week for 4 weeks single-agent rituximab alone versus induction followed by 4 cycles of maintenance therapy every 2 months in patients with follicular lymphoma. Patients and Methods Patients (prior chemotherapy 138; chemotherapy-naive 64) received single-agent rituximab and if nonprogressive, were randomly assigned to no further treatment (observation) or four additional doses of rituximab given at 2-month intervals (prolonged exposure). Results At a median follow-up of 9.5 years and with all living patients having been observed for at least 5 years, the median event-free survival (EFS) was 13 months for the observation and 24 months for the prolonged exposure arm (P < .001). In the observation arm, patients without events at 8 years were 5%, while in the prolonged exposure arm they were 27%. Of previously untreated patients receiving prolonged treatment after responding to rituximab induction, at 8 years 45% were still without event. The only favorable prognostic factor for EFS in a multivariate Cox regression was the prolonged rituximab schedule (hazard ratio, 0.59; 95% CI, 0.39 to 0.88; P = .009), whereas being chemotherapy naive, presenting with stage lower than IV, and showing a VV phenotype at position 158 of the Fc-gamma RIIIA receptor were not of independent prognostic value. No long-term toxicity potentially due to rituximab was observed. Conclusion An important proportion of patients experienced long-term remission after prolonged exposure to rituximab, particularly if they had no prior treatment and responded to rituximab induction.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

Abusive head trauma (AHT) outcome at long-term follow-up and the role of elective neurosurgical approach: A report of 22 cases

2013 ◽  
Author(s):  
Francesca Menegazzo ◽  
Melissa Rosa Rizzotto ◽  
Martina Bua ◽  
Luisa Pinello ◽  
Elisabetta Tono ◽  
...  
Keyword(s):  
Head Trauma ◽  
Abusive Head Trauma ◽  
Long Term Follow Up
Sign in / Sign up

Export Citation Format

Share Document