The LORIS trial is an ongoing phase III clinical trial on low risk ductal carcinoma in situ (DCIS). DCIS patients aged ≥46 years with screen-detected low/intermediate nuclear grade were considered ...low risk and were randomised into surveillance or standard surgery. Here we review the 10-year territory-wide breast cancer registry database and evaluate the clinical outcomes of low versus high risk DCIS patients.
This was a retrospective study of a prospectively maintained territory-wide breast cancer registry in Hong Kong.
Between 1997 and 2006, 1391 DCIS patients were identified from the Hong Kong cancer registry breast cancer database. The mean age at diagnosis was 49.2 years (range 30–70). In total, 372 patients were classified as ‘low risk’, whereas the remaining 777 patients were classified as ‘high risk’. After a median follow-up of 11.6 years, the 10-year overall breast cancer-specific survival of the entire DCIS cohort was 1136/1149 (98.9%). Overall breast cancer-specific survival of low risk DCIS was 99.5%, whereas that in high risk DCIS was 98.6% (Log-rank test, P = 0.208).
Forty-six (12.4%) patients in the LORIS low risk group did not receive surgery, whereas 93 (12%) patients in the LORIS high risk group did not receive surgery. The 10-year breast cancer-specific survival in the non-operated low risk DCIS group was 97.8%; that in the non-operated high risk DCIS group was 96.7% (P = 1).
Long-term survival of DCIS was excellent, especially in low risk DCIS, regardless of surgical treatment.
•Incidence of ipsilateral invasive breast cancer event in patient with ductal carcinoma in situ (DCIS) was 759.4 in 100,000.•Incidence of subsequent invasive breast cancer in low-risk DCIS with or without surgery were comparable.•10-year overall breast cancer specific survival (BCSS) was 98.9%. Overall BCSS of LORIS-low risk and high-risk DCIS were comparable.•10-year BCSS in the non-operated low risk DCIS was 97.8%, and that in the non-operated high-risk DCIS was 96.7%.
Introduction. Many patients remain anxious during intravitreal injections, despite its increasing use. As music can alleviate anxiety for other procedures, we wanted to evaluate its effect during ...intravitreal injection. Methods. Patients undergoing routine intravitreal injection were recruited for a randomized controlled trial. Subjects complete a State-Trait Anxiety Inventory (STAI-S) questionnaire before and after undergoing injection with or without background music. They were also assessed for subjective satisfaction, anxiety, pain, and future preferences after the injection. Results. There were 39 and 37 Chinese subjects in the music (age 68.08 ± 13.67) and control (age 73.24 ± 11.17) groups, respectively. The music group reported lower anxiety and pain, and a greater reduction in STAI-S score, but the differences were not statistically significant (P=0.830, 0.655, 0.199, respectively). More subjects in the music group (92.3%, control group 64.9%) preferred music for future injections (P=0.003). Age, but not the number of previous injections, was negatively correlated with reported anxiety (r = −0.27, P=0.021). Conclusion. Most subjects preferred music during future injections. Although music reduced anxiety, the effect was not statistically significant and may be masked by the higher age of our control group, as increasing age was correlated with lower anxiety.
Pancreatic cancer has been associated with lifestyle factors, but few comparative studies were conducted among countries of different culture and lifestyle habits. This study compared the trends of ...pancreatic cancer incidence and birth cohort effects in the United States and urban China and explored the potential discrepancies of risk patterns.
Age-standardized incidence rates (ASIRs) were calculated using data from national or regional cancer registries of the United States and two large cities of China (Shanghai, Hong Kong). The temporal trends of incidence were assessed by joinpoint regression. The effects of birth cohort and calendar period were identified through age–period–cohort modeling.
The ASIR in the United States from 1976 to 2015 was 8.26/100 000, which was higher than that in Hong Kong (4.29/100 000) and Shanghai of China (6.63/100 000). Shanghai had lower incidence (4.41/100 000) in 1976-1980 but increased annually by 1.38% in males and 1.67% in females, with a sharper upward trend than the United States and Hong Kong. Males had higher risks than females, with a male-to-female ratio of 1.34, 1.44, and 1.37 in the United States, Hong Kong, and Shanghai, respectively. A significant and prominent increase in incidence rate was observed among successive generations in China particularly for Shanghai, but such a pattern was not apparent in the United States.
The differences in pancreatic cancer incidence by sex may be multi-factorial involving known risk factors like tobacco smoking and alcohol consumption. The significant birth cohort effects among recent and early generations in the Shanghai population were in line with a society in socioeconomic transition and adoption of Western lifestyle mainly including consumption of calorie-rich foods and physical inactivity. Differences in these risk patterns will have implications on health care efforts and policies for cancer control.
•The ASIR of pancreatic cancer in the U.S. is higher than that in urban China.•Higher risk of pancreatic cancer was observed in the youth of urban China, but this pattern was not prominent in the U.S.•The disparities of birth cohort effects are consistent with a society in socioeconomic transition.
The overall decline in incidence rate of nasopharyngeal carcinoma in Hong Kong during 1988-2002 was limited primarily to a decrease in keratinising carcinoma, which could be explained by the decline ...in cigarette smoking. Genetic and Epstein-Barr virus interactions may explain the relatively stable incidence rate of non-keratinising carcinoma.
Instrumental neutron activation analysis (INAA) was applied for the accurate and precise determination of minor and trace elements in small-sized aliquants (1 to 2 mg) of two certified reference ...materials (CRM), NIES No. 8 and NIST 1632c. Four laboratories used either comparative- or k0-INAA, or both, and repeated the analysis more than ten times for each CRM. Based on z-scores and zeta scores of analytical data, QA/QC in analyzing such small scale of the two reference samples was assessed, revealing that there was a clear difference in the analytical ability among participating laboratories. It was concluded that the two CRM samples on the mg scale can be used as reference samples in INAA of a similarly small-scaled sample, at least for the 16 – 18 elements examined.
The current treatment options for chronic subdural hematoma (CSDH) include burr hole drainage, twist drill drainage, and craniotomy with or without postoperative catheter drainage. Although generally ...effective, these treatments have continued to be complicated by recurrence, especially in partially hemolyzed or septated hematomas. Recently, interest in the use of fibrinolytic agents as an adjunct to surgical treatment to address this limitation has been increasing. We conducted a systematic review, focusing on the efficacy and safety profile of fibrinolytic agents and compared the different fibrinolytic agents.
The PubMed, EMBASE, CINAHL Plus, and Cochrane Library databases were searched for trials relevant to fibrinolytic administration in the treatment of CSDH. The findings are reported in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. The data from 1702 subjects from 6 retrospective observational studies were qualitatively analyzed. In addition, we included 11 case series and reports for discussion.
For 1449 patients, the use of urokinase or tissue plasminogen activator improved hematoma drainage and shortened the hospital stay (7.04 days), with an overall hematoma recurrence rate of 1.59%. The incidence of infection, seizure, and intracranial bleeding was 3.18%, 0.80%, and 0.41%, respectively, which compared favorably with previously reported findings for surgical drainage without the use of fibrinolytic agents.
The routine use of intrathecal urokinase and tissue plasminogen activator could be a new direction in the management of CSDH. Conclusive clinical evidence is lacking, however, and further prospective controlled studies are warranted to confirm the benefit and safety of this treatment strategy and to identify the optimal agent and dosing regimen.
For the first time an excess of photons above an energy threshold of 730 GeV from the giant radio galaxy M 87 has been measured at a significance level above 4 σ. The data have been taken during the ...years 1998 and 1999 with the HEGRA stereoscopic system of 5 imaging atmospheric Cherenkov telescopes. The excess of $107.4\,\pm\,26.8$ events above 730 GeV corresponds to an integral flux of 3.3% of the Crab flux or $N_\gamma(E > 730\,\mbox{GeV}) = (0.96 \pm 0.23) \times 10^{-12}$ phot cm-2 s-1. M 87 is located at the center of the Virgo cluster of galaxies at a relatively small redshift of $z = 0.00436$ and is a promising candidate among the class of giant radio galaxies for the emission of TeV γ-radiation. The detection of TeV γ-rays from M 87 – if confirmed – would establish a new class of extragalactic source in this energy regime since all other AGN detected to date at TeV energies are BL Lac type objects.
The Hong Kong cancer registry was established in 1963, and cancer registration is done by passive and active methods. The registry contributed data on 45 cancer sites or types registered during ...1996-2001 for this survival study. Follow-up has been carried out by passive methods with median follow-up ranging from 4-60 months. The proportion of cases with histologically verified cancer diagnosis ranged from 38-100%; death certificates only (DCOs) ranged from 0-11%; 83-99% of total registered cases were included for survival analysis. The 5-year age-standardized relative survival exceeded 100% for lip and non-melanoma skin followed by thyroid (94%) and testicular (92%) cancers. The corresponding survival for common cancers were breast (90%), colon (61%), liver and Lung (22%), nasopharynx (70%), rectum (59%) and stomach (39%). The 5-year relative survival by age group showed a decreasing trend with increasing agegroups for most cancers. A decreasing survival with increasing clinical extent of disease was noted.
TeV γ-rays from the BL Lac object 1ES 1959+650 have been measured during the years 2000 and 2001 with a significance of 5.2 σ at a value of 5.3% of the Crab flux and in May 2002 during strong ...outbursts with >$23\,\sigma$ at a flux level of up to 2.2 Crab, making 1ES 1959+650 the TeV Blazar with the third best event statistics. The deep observation of 197.4 h has been performed with the HEGRA stereoscopic system of 5 imaging atmospheric Cherenkov telescopes (IACT system). 1ES 1959+650 is located at a redshift of $z = 0.047$, providing an intermediate distance between the nearby Blazars Mkn 421 and Mkn 501, and the much more distant object H1426+428. This makes 1ES 1959+650 an important member of the class of TeV Blazars in view of the absorption of TeV photons by the diffuse extragalactic background radiation (DEBRA). The differential energy spectrum of 1ES 1959+650 during the flares can be fitted by a power law with a spectral index of $2.83 \pm 0.14_{\mbox{\tiny stat}} \pm 0.08_{\mbox{\tiny sys}}$ or by a power law with an exponential cut-off at $(4.2^{+0.8}_{-0.6~{\mbox{\tiny stat}}} \pm 0.9_{\mbox{\tiny sys}})$ TeV and a spectral index of $1.83 \pm 0.15_{\mbox{\tiny stat}} \pm 0.08_{\mbox{\tiny sys}}$. The low state differential energy spectrum obtained with lower statistics can be described by a pure power law with a spectral index of $3.18 \pm 0.17_{\mbox{\tiny stat}} \pm 0.08_{\mbox{\tiny sys}}$.
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