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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  27. Deutscher Krebskongress; 20060322-20060326; Berlin; DOCOP538 /20060320/
    Publication Date: 2006-04-21
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  27. Deutscher Krebskongress; 20060322-20060326; Berlin; DOCOP533 /20060320/
    Publication Date: 2006-04-21
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie; 20050912-20050915; Freiburg im Breisgau; DOC05gmds069 /20050908/
    Publication Date: 2005-09-09
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 4
    Keywords: CANCER ; Germany ; THERAPY ; DIAGNOSIS ; PATIENT ; IMPACT ; INTERVENTION ; treatment ; BREAST ; breast cancer ; BREAST-CANCER ; PATTERNS ; AGE ; WOMEN ; CLINICAL-TRIALS ; CANCER-PATIENTS ; PREDICTORS ; CANCER PATIENTS ; QUESTIONNAIRE ; LONG-TERM SURVIVORS ; breast neoplasms ; ONCOLOGY ; REGRESSION ; RE ; DISTRESS ; LIFE ; quality of life ; SURVIVORS ; IMPAIRMENT ; FATIGUE ; EUROPEAN-ORGANIZATION ; ADJUVANT CHEMOTHERAPY ; NAUSEA ; function ; female ; multivariate analysis ; population-based ; PREDICTOR ; health status ; SOCIODEMOGRAPHIC FACTORS
    Abstract: BACKGROUND. Whereas the role of specific symptoms, such as pain and fatigue, for quality of life (QOL) is unquestioned, their relative importance for long-lasting impairments in QOL in cancer patients has rarely been assessed quantitatively. The authors, therefore, aimed to identify symptoms most predictive of limitations to function and overall QOL in women with breast cancer after completion of primary therapy. METHODS. The European Organisation for Research and Treatment of Cancer questionnaire QLQ-C30 and the breast-cancer-specific module QLQ-BR23 were used to measure QOL in a population-based sample from Saarland (Germany) of 314 women with breast cancer 1 year after diagnosis. Symptoms most predictive for limitations to function and overall QOL were identified with a multiple linear regression analysis. RESULTS. Fatigue emerged as the strongest predictor by far of QOL, explaining around 30% to 50% of variability within function scores and overall QOL. Other symptoms, including pain, nausea and/or vomiting, breast symptoms, systemic therapy side effects, and arm symptoms, explained on average 〈 5% of variability of various QOL scales beyond fatigue and age. Sociodemographic and clinical factors had little impact on QOL. CONCLUSIONS. Although QOL is a multidimensional concept, the analysis suggested that fatigue is the symptom that had, by far, the largest impact on limiting function and on overall QOL in breast cancer patients after their completion of primary therapy. Specific interventions to reduce the burden of fatigue may represent a particularly worthwhile effort to improve QOL in women with breast cancer
    Type of Publication: Journal article published
    PubMed ID: 17048250
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  • 5
    Keywords: Germany ; MODEL ; screening ; COHORT ; EPIDEMIOLOGY ; HISTORY ; IMPACT ; HEALTH ; HUMANS ; WOMEN ; MEN ; OBESITY ; smoking ; BODY ; body mass index ; SMOKERS ; MASS INDEX ; ADULT ; ADULTS ; WEIGHT ; body weight ; INTERVAL ; analysis ; methods ; GENDER ; PARTICIPANTS ; OVERWEIGHT ; female ; Male ; cohort analysis ; smoking cessation ; multivariate analysis ; BMI ; RELEVANCE ; Aged ; Middle Aged ; retrospective ; Retrospective Studies ; CESSATION ; statistics & numerical data
    Abstract: OBJECTIVE: To assess the relevance of pre-existing body weight for successful smoking cessation among women and men. METHODS: We carried out a retrospective cohort analysis among 4270 ever smoking participants of a general health screening examination in Germany recruited from July 2000 to June 2002 aged 50 to 74, who provided lifetime histories of both body weight and smoking. RESULTS: In the extended Cox model, the relative cessation rate (RCR) increased significantly with increasing body mass index (BMI) among both genders (test for trend: P 〈 0.01 for women and P 〈 0.0001 for men). In women, this effect was mainly due to a lower cessation rate in low-weight (BMI 〈20) smokers (adjusted RCR = 0.76, 95% confidence interval (CI) 0.62-0.95), whereas in men, the effect was mainly due to a higher cessation rate among overweight and obese smokers (adjusted RCR = 1.26, 95% CI 1.11-1.35, and 1.38, 95% CI 1.17-1.63, respectively) compared to normal-weight smokers. CONCLUSIONS: While in men, overweight and obesity are associated with increased smoking cessation, possibly related to increased health concerns, in women, low weight is associated with decreased smoking cessation, possibly related to increased fear of weight gain
    Type of Publication: Journal article published
    PubMed ID: 16336994
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  • 6
    Keywords: CANCER ; SURVIVAL ; ALGORITHM ; CLASSIFICATION ; FOLLOW-UP ; SUPPORT ; DEATH ; DISEASE ; DISEASES ; incidence ; POPULATION ; SEQUENCE ; HUMANS ; quality control ; DATABASE ; MORPHOLOGY ; EUROPE ; ADULT ; REGISTRY ; cancer registries ; RELATIVE SURVIVAL ; epidemiologic methods ; LIFE ; methods ; statistical analysis ; CANCERS ; cancer survival ; ERROR ; EUROCARE-4 ; PROPORTION ; Data quality ; Databases as Topic/*standards ; Europe/epidemiology ; Neoplasms/*mortality
    Abstract: This paper describes the collection, standardisation and checking of cancer survival data included in the EUROCARE-4 database. Methods for estimating relative survival are also described. Incidence and vital status data on newly diagnosed European cancer cases were received from 93 cancer registries in 23 countries, covering 151,400,000 people (35% of the participating country population). The third revision of the International Classification of Diseases for Oncology was used to specify tumour topography and morphology. Records were extensively checked for consistency and compatibility using multiple routines; flagged records were sent back for correction. An algorithm assigned standardised sequence numbers to multiple cancers. Only first malignant cancers were used to estimate relative survival from registry, year, sex and age-specific life tables. Age-adjusted and Europe-wide survival were also estimated. The database contains 13,814,573 cases diagnosed in 1978-2002; 92% malignant. A negligible proportion of records was excluded for major errors. Of 5,753,934 malignant adult cases diagnosed in 1995-2002, 5.3% were second or later cancers, 2.7% were known from death certificates only and 0.4% were discovered at autopsy. The remaining 5,278,670 cases entered the survival analyses, 90% of these had microscopic confirmation and 1.3% were censored alive after less than five years' follow-up. These indicators suggest satisfactory data quality that has improved since EUROCARE-3.
    Type of Publication: Journal article published
    PubMed ID: 19128955
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  • 7
    Keywords: CANCER ; SURVIVAL ; DIAGNOSIS ; SUPPORT ; PATIENT ; prognosis ; SKIN ; treatment ; BREAST ; STAGE ; MALIGNANCIES ; CARE ; HUMANS ; AGE ; MELANOMA ; SWEDEN ; REGION ; CANCER-PATIENTS ; CANCER PATIENTS ; COMORBIDITY ; FINLAND ; MALIGNANCY ; ADULT ; REGISTRY ; cancer registries ; ELDERLY-PATIENTS ; RELATIVE SURVIVAL ; elderly patients ; elderly ; survival analysis ; female ; Male ; EUROPEAN COUNTRIES ; CANCERS ; REGISTRIES ; Aged ; Middle Aged ; UK ; 3 ; EUROCARE-4 ; Europe/epidemiology ; Neoplasms/*mortality ; Adolescent ; Age Distribution ; Sex Distribution
    Abstract: EUROCARE-4 analysed about three million adult cancer cases from 82 cancer registries in 23 European countries, diagnosed in 1995-1999 and followed to December 2003. For each cancer site, the mean European area-weighted observed and relative survival at 1-, 3-, and 5-years by age and sex are presented. Country-specific 1- and 5-year relative survival is also shown, together with 5-year relative survival conditional to surviving 1-year. Within-country variation in survival is analysed for selected cancers. Survival for most solid cancers, whose prognosis depends largely on stage at diagnosis (breast, colorectum, stomach, skin melanoma), was highest in Finland, Sweden, Norway and Iceland, lower in the UK and Denmark, and lowest in the Czech Republic, Poland and Slovenia. France, Switzerland and Italy generally had high survival, slightly below that in the northern countries. There were between-region differences in the survival for haematologic malignancies, possibly due to differences in the availability of effective treatments. Survival of elderly patients was low probably due to advanced stage at diagnosis, comorbidities, difficult access or lack of availability of appropriate care. For all cancers, 5-year survival conditional to surviving 1-year was higher and varied less with region, than the overall relative survival.
    Type of Publication: Journal article published
    PubMed ID: 19171476
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  • 8
    Keywords: CELLS ; TISSUE ; GRAFTS ; RE-ENDOTHELIALIZATION ; ENGINEERED HEART-VALVES
    Abstract: Cell-matrix interactions in a three-dimensional (3D) extracellular matrix (ECM) are of fundamental importance in living tissue, and their in vitro reconstruction in bioartificial structures represents a core target of contemporary tissue engineering concepts. For a detailed analysis of cell-matrix interaction under highly controlled conditions, we developed a novel ECM evaluation culture device (EECD) that allows for a precisely defined surface-seeding of 3D ECM scaffolds, irrespective of their natural geometry. The effectiveness of EECD was evaluated in the context of heart valve tissue engineering. Detergent decellularized pulmonary cusps were mounted in EECD and seeded with endothelial cells (ECs) to study EC adhesion, morphology and function on a 3D ECM after 3, 24, 48 and 96 h. Standard EC monolayers served as controls. Exclusive top-surface-seeding of 3D ECM by viable ECs was demonstrated by laser scanning microscopy (LSM), resulting in a confluent re-endothelialization of the ECM after 96 h. Cell viability and protein expression, as demonstrated by MTS assay and western blot analysis (endothelial nitric oxide synthase, von Willebrand factor), were preserved at maintained levels over time. In conclusion, EECD proves as a highly effective system for a controlled repopulation and in vitro analysis of cell-ECM interactions in 3D ECM.
    Type of Publication: Journal article published
    PubMed ID: 22761130
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  • 9
    Keywords: CANCER ; SURVIVAL ; Germany ; LUNG ; DIAGNOSIS ; lung cancer ; LUNG-CANCER ; DISEASE ; DISEASES ; incidence ; LONG-TERM ; MORTALITY ; SITE ; SITES ; CONTRAST ; treatment ; BREAST ; breast cancer ; BREAST-CANCER ; early detection ; prevention ; primary prevention ; LYMPHOMA ; HEALTH ; statistics ; cervical cancer ; CERVICAL-CANCER ; COUNTRIES ; PROSTATE-CANCER ; RATES ; STATISTICAL-ANALYSIS ; STOMACH ; FUTURE ; FAILURE ; DECLINE ; TRENDS ; EUROPE ; REGISTRY ; REGRESSION ; RE ; cancer registries ; INCREASE ; CARDIOVASCULAR-DISEASE ; TRANSLATION ; TESTICULAR CANCER ; HEALTH-CARE ; analysis ; methods ; cancer registry ; CANCER INCIDENCE ; female ; Male ; CANCERS ; REGISTRIES ; CANCER-MORTALITY ; cardiovascular disease ; cardiovascular diseases ; cancer registration ; descriptive epidemiology ; joinpoint regression
    Abstract: Purpose The paper presents the statistical analysis of current and past trends of cancer mortality rates in Germany in terms of annual percent change, overall and for the major sites, and contrasts them with trends in incidence of the Cancer Registry of the Saarland, the only registry in this country with long-term completeness. It addresses also the issue of a cross-over of cancer mortality and mortality from cardiovascular diseases (CVD) in the near future, as suggested by various authors. Methods Analyses are based on the mortality data of the official mortality statistics as published by the Federal Statistical Office and reported annually to the WHO, and the regularly reported incidence data of the Cancer Registry of the Saarland. The data was age-standardised and analysed by piecewise regression using a freely available dedicated software package. Results The report shows a downward trend of mortality rates for all cancers combined based on declining rates for many individual sites with only few exceptions affecting mainly females (e.g. lung cancer). Recently, the long-term increase of cancer incidence also flattened out with rather heterogeneous underlying site-specific trends increasing for some sites (e.g. cancers of the intestine, breast, prostate, or some lymphoma) and decreasing for others (e.g. cancers of the stomach, gall bladder in females, larynx, and lung in males). A crossover of cancer mortality and mortality from CVD might occur-if at all-after 2,020 in males and 2,030 in females. Conclusions Depending on cancer site, primary prevention (e.g. lung cancer among males), early detection (cervical cancer), and treatment (e.g. breast and testicular cancer, lymphoma) contributed to the current decline of mortality rates. Absence of a turnaround (e.g. lung cancer among females), slower decline than in other countries (e.g. cervical cancer), or later turnaround (e.g. breast cancer) may be related to failures in promoting prevention (lung cancer among females), early detection programmes (cervical cancer), or delays in the translation of modern treatment into routine health care (breast cancer) and indicate major challenges for current and future health policy
    Type of Publication: Journal article published
    PubMed ID: 16896882
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  • 10
    Keywords: CANCER ; Germany ; THERAPY ; DIAGNOSIS ; COHORT ; cohort study ; EPIDEMIOLOGY ; LONG-TERM ; NEW-YORK ; POPULATION ; SURGERY ; TIME ; PATIENT ; primary ; QUALITY ; BREAST ; breast cancer ; BREAST-CANCER ; STAGE ; DIFFERENCE ; WOMEN ; CONSERVATION ; CANCER-PATIENTS ; OUTCOMES ; CANCER PATIENTS ; QUESTIONNAIRE ; BODIES ; ONCOLOGY ; RE ; THERAPIES ; aging ; INCREASE ; PERIOD ANALYSIS ; QUALITY-OF-LIFE ; quality of life ; SURVIVORS ; methods ; EUROPEAN-ORGANIZATION ; USA ; population-based ; EORTC QLQ-C30 ; VALUES ; BODY-IMAGE ; Breast-conserving therapy ; Mastectomy ; PSYCHOLOGICAL MORBIDITY ; RADICAL-MASTECTOMY
    Abstract: Purpose Breast-conserving therapy (BCT) was developed to improve quality of life (QOL) in early stage breast cancer patients. Except for differences in body image, literature comparing the psychosocial sequelae of BCT with mastectomy is ambiguous and shows a lack of substantial benefits. However, knowledge regarding long term effects of treatment on QOL in breast cancer is very limited as most of the pertinent studies have been performed in the early post-operative period. Therefore we compared QOL in women with breast cancer undergoing BCT versus women undergoing mastectomy over a 5-year period following primary surgery. Methods QOL was assessed at 1, 3, and 5 years after diagnosis in a population based cohort of 315 women with early stage breast cancer (UICC stage I-II) from Saarland (Germany) using the EORTC QLQ-C30 questionnaire and the breast cancer specific module BR23. Results Breast-conserving therapy was performed in 226 women (72%). After control for potential confounding, women with BCT reported better physical and role functioning, were sexually more active and more satisfied with their body image already at 1 year after diagnosis (all P values 〈 0.05). Differences in overall QOL and social functioning were gradually increasing over time and became statistically significant only at 5 years. Conclusions Whereas some, very specific benefits of BCT, such as a better body image, are already visible very timely after completion of therapy, benefits in broader measures such as psychosocial well-being and overall quality of life gradually increase over time and become fully apparent only in the long run
    Type of Publication: Journal article published
    PubMed ID: 18504613
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