Survival after Locoregional Recurrence or Second Primary Breast Cancer: Impact of the Disease-Free Interval

The association between the disease-free interval (DFI) and survival after a locoregional recurrence (LRR) or second primary (SP) breast cancer remains uncertain. The objective of this study is to clarify this association to obtain more information on expected prognosis. Women first diagnosed with early breast cancer between 2003–2006 were selected from the Netherlands Cancer Registry. LRRs and SP tumours within five years of first diagnosis were examined. The five-year period was subsequently divided into three equal intervals. Prognostic significance of the DFI on survival after a LRR or SP tumour was determined using Kaplan-Meier estimates and multivariable Cox regression analysis. Follow-up was complete until January 1, 2014. A total of 37,278 women was included in the analysis. LRRs or SP tumours were diagnosed in 890 (2,4%) and 897 (2,4%) respectively. Longer DFI was strongly and independently related to an improved survival after a LRR (long versus short: HR 0.65, 95% CI 0.48–0.88; medium versus short HR 0.81, 95% CI 0.65–1.01). Other factors related to improved survival after LRR were younger age (<70 years) and surgical removal of the recurrence. No significant association was found between DFI and survival after SP tumours. This is the first study to explore the association between the DFI and survival after recurrence in a nationwide population-based cancer registry. The DFI before a LRR is an independent prognostic factor for survival, with a longer DFI predicting better prognosi

Opposite incidence trends for differentiated and medullary thyroid cancer in young dutch patients over a 30‐year time span

Thyroid cancer is the most common endocrine malignancy in children. A rising incidence has been reported worldwide. Possible explanations include the increased use of enhanced imaging (leading to incidentalomas) and an increased prevalence of risk factors. We aimed to evaluate the incidence and survival trends of thyroid cancer in Dutch children, adolescents, and young adults (0–24 years) between 1990 and 2019. The age-standardized incidence rates of differentiated thyroid cancer (DTC, including papillary and follicular thyroid cancer (PTC and FTC, respectively)) and medullary thyroid cancer (MTC), the average annual percentage changes (AAPC) in incidence rates, and 10-year overall survival (OS) were calculated based on data obtained from the nationwide cancer registry (Netherlands Cancer Registry). A total of 839 patients aged 0–24 years had been diagnosed with thyroid carcinoma (PTC: 594 (71%), FTC: 128 (15%), MTC: 114 (14%)) between 1990 and 2019. The incidence of PTC increased significantly over time (AAPC +3.6%; 95%CI +2.3 to +4.8), the incidence rate of FTC showed a stable trend ((AAPC −1.1%; 95%CI −3.4 to +1.1), while the incidence of MTC decreased significantly (AAPC: −4.4% (95%CI −7.3 to −1.5). The 10-year OS was 99.5% (1990–1999) and 98.6% (2000–2009) in patients with DTC and 92.4% (1990–1999) and 96.0% (2000–2009) in patients with MTC. In this nationwide study, a rising incidence of PTC and decreasing incidence of MTC were observed. For both groups, in spite of the high proportion of patients with lymph node involvement at diagnosis for DTC and the limited treatment options for MTC, 10-year OS was high

Opposite Incidence Trends for Differentiated and Medullary Thyroid Cancer in Young Dutch Patients over a 30-Year Time Span (vol 13, 5104, 2021)

Error in Figure In the original article [1], there was a mistake in Figure 1 as published. In this figure, two years are missing (2000 and 2001). The AAPC values as previously published are correct. The corrected Figure 1 appears below. In addition, in the original article, there was a mistake in Figure 2A–C as published. In these figures, two years are missing (2000 and 2001). The AAPC values were correct and do not require adjustment. The corrected Figure 2A–C appears below. The authors apologize for any inconvenience caused and state that the scientific conclusions are unaffected. The original article has been updated. (figure presented)

Report on cancer registry indicators in various countries

Since the fifties cancer registries have provided population-based, comparative survival statistics for cancer patients. EUROCARE (a co-operative, cancer registry-based project) has collected and analysed survival data on patients diagnosed since 1978. Its reports underlined large differences in cancer survival across Europe. The most recent evaluation on cancer survival among patients diagnosed in 2000-2002 (EUROCARE-4 study) showed highest survival rates in the northern European countries and lowest for those in the eastern European countries. Patients in Eastern Europe had the highest improvement in survival for major cancer sites during 1991-2002

Attending the breast screening programme after breast cancer treatment:A population-based study

<p>Introduction: In the Netherlands, breast cancer patients are treated and followed at least 5 years after diagnosis. Furthermore, all women aged 50-74 are invited biennially for mammography by the nationwide screening programme. The relation between the outpatient follow-up (follow-up visits in the outpatient clinic for 5 years after treatment) and the screening programme is not well established and attending the screening programme as well as outpatient follow-up is considered undesirable. This study evaluates potential factors influencing women to attend the screening programme during their outpatient follow-up (overlap) and the (re-)attendance to the screening programme after 5 years of outpatient follow-up.</p><p>Methods: Data of breast cancer patients aged 50-74 years, treated for primary breast cancer between 1996 and 2007 were selected from the Netherlands Cancer Registry and linked to the National Breast Cancer Screening Programme in the Northern region. Cox regression analyses were used to study women (re-) attending the screening programme over time, possible overlap with the outpatient follow-up and factors influencing this.</p><p>Results: In total 11 227 breast cancer patients were included, of whom 19% attended the screening programme after breast cancer treatment, 4.4% within 5 years and 15.4% after more than 5 years. Factors that independently influenced attendance within 5 years as well as more than 5 years after treatment were: interval tumours (HR 0.77; 95% CI 0.61-0.97 and HR 0.69; 95% CI 0.53-0.88, ref: screen-detected tumours), receiving adjuvant radiotherapy (HR 0.65; 95% CI 0.47-0.90 and HR 0.66; 95% CI 0.47-0.93; ref: none) and diagnosis of in situ tumours (HR 1.67; 95% CI 1.25-2.23 and HR 1.39; 95% CI 1.05-1.85; ref: stage I tumours). Non-screen related tumours (HR 0.41; 95% CI 0.29-0.58) and recent diagnosis (HR 0.89 per year; 95% CI 0.86-0.92) were only associated with attendance within 5 years after treatment.</p><p>Conclusion: The interrelation between outpatient follow-up and screening should be improved to avoid overlap and low attendance to the screening programme after outpatient follow-up. Breast cancer patients should be informed that attending the screening programme during the outpatient follow-up is not necessary. (C) 2013 Elsevier Ltd. All rights reserved.</p>

Multivariable Cox regression analysis after multiple imputation.

<p>Abbreviations: HR = hazard rate, CI = Confidence Interval, DFI = disease-free interval, LR = local recurrence, RR = regional recurrence, LRR = locoregional recurrence, SP = second primary, ER = oestrogen receptor, PR = progesterone receptor, na = not applicable.</p><p>* indicates most influencing factors.</p><p>Multivariable Cox regression analysis after multiple imputation.</p

Primary treatment and recurrence characteristics, for LRRs stratified by length of the DFI and tested for differences between the DFI groups.

<p>Abbreviations: LRR = locoregional recurrence, SP = second primary, LR = local recurrence, RR = regional recurrence, na = not applicable.</p><p>Primary treatment and recurrence characteristics, for LRRs stratified by length of the DFI and tested for differences between the DFI groups.</p

Patient and primary tumour characteristics, for LRRs stratified by length of the DFI and tested for differences between the DFI groups.

<p>Abbreviations: LRR = locoregional recurrence, SP = second primary, DFI = disease-free interval, ER = oestrogen receptor, PR = progesterone receptor, Her2-Neu = human epidermal growth factor receptor 2</p><p>Patient and primary tumour characteristics, for LRRs stratified by length of the DFI and tested for differences between the DFI groups.</p

Treatment of the primary tumour against the treatment of SP tumours.

<p>* indicates a significant difference. Abbreviations: SP = second primary.</p><p>Treatment of the primary tumour against the treatment of SP tumours.</p