Cohort profile : a nationwide population-based retrospective assessment of oesophageal cancer in the Finnish National Esophago-Gastric Cancer Cohort (FINEGO)

Purpose The Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established to combine the available registry data with detailed patient information to form a comprehensive, retrospective, population-based research platform of surgically treated oesophageal and gastric cancer in Finland. This cohort profile describes the 2045 surgically treated patients with oesophageal cancer included in the FINEGO cohort. Participants Registry data were collected from the National Cancer, Patient, Education and Death Registries from 1 January 1987 to 31 December 2016. All patients over 18 years of age, who had either curative surgery, palliative surgery or salvage surgery for primary cancer in the oesophagus are included in this study. Findings to date 2045 patients had surgery for oesophageal cancer in the selected time period. 67.2% were man, and the majority had only minor comorbidities. The proportions of adenocarcinomas and squamous cell carcinomas were 43.1% and 44.4%, respectively, and 12.5% had other or missing histology. Only about 23% of patients received neoadjuvant therapy. Oesophagectomy was the treatment of choice and most patients were treated at low-volume centres, but median annual hospital volume increased over time. Median overall survival was 23 months, 5-year survival for all patients in the cohort was 32.9% and cancer-specific survival was 36.5%. Future plans Even though Finland only has a population of 5.5 million, surgery for oesophageal carcinoma has not been centralised and therefore previously reported results have mostly been small, single-centre cohorts. Because of FINEGO, we now have a population-based, unselected cohort of surgically treated patients, enabling research on national trends over time regarding oesophageal cancer, including patient characteristics, tumour histology, stage and neoadjuvant treatment, surgical techniques, hospital volumes and patient mortality. Data collection is ongoing, and the cohort will be expanded to include more detailed data from patient records and national biobanks.Peer reviewe

Cohort profile: gastric cancer in the population-based, Finnish National Esophago-Gastric Cancer Cohort (FINEGO) Study

Purpose The Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established with the aim of identifying factors that could contribute to improved outcomes in oesophago-gastric cancer. The aim of this study is to describe the patients with gastric cancer included in FINEGO. Participants A total of 10 457 patients with gastric cancer or tumour diagnosis in the Finnish Cancer Registry or the Finnish Patient Registry during 1987-2016 were included in the cohort, with follow-up from Causes of Death Registry until 31 December 2016. All of the participants were at least 18 years of age, and had undergone either resectional or endoscopic mucosal surgery with curative or palliative intent. Findings to date Of the 10 457 patients, 90.1% were identified to have cancer in both cancer and patient registries. In all, the median age was 70 at the time of surgery, 54.5% of the patients were men and 64.4% had no comorbidities. Education data were available for 31.1% of the patients, of whom the majority had had Future plans The data in FINEGO can be currently used for registry-based research but is being expanded by data extraction from patient records and scanning of histological samples from the Finnish biobanks. Initially, we are planning on studies on the national trends in treatment and mortality, and studies on the demographic factors and their influence on survival.</div

Cohort profile: a nationwide population-based retrospective assessment of oesophageal cancer in the Finnish National Esophago-Gastric Cancer Cohort (FINEGO)

Purpose The Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established to combine the available registry data with detailed patient information to form a comprehensive, retrospective, population-based research platform of surgically treated oesophageal and gastric cancer in Finland. This cohort profile describes the 2045 surgically treated patients with oesophageal cancer included in the FINEGO cohort. Participants Registry data were collected from the National Cancer, Patient, Education and Death Registries from 1 January 1987 to 31 December 2016. All patients over 18 years of age, who had either curative surgery, palliative surgery or salvage surgery for primary cancer in the oesophagus are included in this study. Findings to date 2045 patients had surgery for oesophageal cancer in the selected time period. 67.2% were man, and the majority had only minor comorbidities. The proportions of adenocarcinomas and squamous cell carcinomas were 43.1% and 44.4%, respectively, and 12.5% had other or missing histology. Only about 23% of patients received neoadjuvant therapy. Oesophagectomy was the treatment of choice and most patients were treated at low-volume centres, but median annual hospital volume increased over time. Median overall survival was 23 months, 5-year survival for all patients in the cohort was 32.9% and cancer-specific survival was 36.5%. Future plans Even though Finland only has a population of 5.5 million, surgery for oesophageal carcinoma has not been centralised and therefore previously reported results have mostly been small, single-centre cohorts. Because of FINEGO, we now have a population-based, unselected cohort of surgically treated patients, enabling research on national trends over time regarding oesophageal cancer, including patient characteristics, tumour histology, stage and neoadjuvant treatment, surgical techniques, hospital volumes and patient mortality. Data collection is ongoing, and the cohort will be expanded to include more detailed data from patient records and national biobanks

Long-Term Survival After Transhiatal Versus Transthoracic Esophagectomy : A Population-Based Nationwide Study in Finland

Background No population-based studies comparing long-term survival after transhiatal esophagectomy (THE) and transthoracic esophagectomy (TTE) exist. This study aimed to compare the 5-year survival of esophageal cancer patients undergoing THE or TTE in a population-based nationwide setting. Methods This study included all curatively intended THE and TTE for esophageal cancer in Finland during 1987-2016, with follow-up evaluation until 31 December 2019. Cox proportional hazard models provided hazard ratios (HRs) with 95% confidence intervals (CIs) of 5-year and 90-day mortality. The results were adjusted for age, sex, year of operation, comorbidities, histology, neoadjuvant treatment, and pathologic stage. Results A total of 1338 patients underwent THE (n = 323) or TTE (n = 1015). The observed 5-year survival rate was 39.3% after THE and 45.0% after TTE (p = 0.072). In adjusted model 1, THE was not associated with greater 5-year mortality (HR 0.99; 95% CI 0.82-1.20) than TTE. In adjusted model 2, including T stage instead of pathologic stage, the 5-year mortality hazard rates after THE (HR 0.87, 95% CI 0.72-1.05) and TTE were comparable. The 90-day mortality rate for THE was higher than for TTE (adjusted HR 0.72; 95% CI 0.45-1.14). In subgroup analyses, no differences between THE and TTE were observed in Siewert II gastroesophageal junction cancers, esophageal cancers, or pN0 tumors, nor in the comparison of THE and TTE with two-field lymphadenectomy. The sensitivity analysis, including patients with missing patient records, who underwent surgery during 1996-2016 mirrored the main analysis. Conclusions This Finnish population-based nationwide study suggests no difference in 5-year or 90-day mortality after THE and TTE for esophageal cancer.Peer reviewe

Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland

Publisher Copyright: © 2021Background: The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer. Materials and methods: This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume. Results: Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality. Conclusion: In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.Peer reviewe

Preoperative Esophageal Stenting and 5-Year Survival in Patients Undergoing Esophagectomy for Esophageal Cancer : a Population-Based Nationwide Study from Finland

Background: Preoperative esophageal stenting is proposed to have a negative effect on outcomes. The aim was to compare a 5-year survival in patients undergoing esophagectomy for esophageal cancer with and without preoperative esophageal stent in a population-based nationwide cohort from Finland. The secondary outcome was 90-day mortality. Methods: This study included curatively intended esophagectomies for esophageal cancer in Finland between 1999 and 2016, with follow-up until December 31, 2019. Cox proportional hazards models provided hazard ratios (HRs) with 95% confidence intervals (CIs) of overall 5-year and 90-day mortality. Model 1 was adjusted for age, sex, year of the surgery, comorbidities, histology, pathological stage, and neoadjuvant therapy. Model 2 included also albumin level and BMI. Result: Of 1064 patients, a total of 134 patients underwent preoperative stenting and 930 did not. In both adjusted models 1 and 2, higher 5-year mortality was seen in patients with preoperative stent with HRs of 1.29 (95% CI 1.00–1.65) and 1.25 (95% CI 0.97–1.62), respectively, compared to no stenting. The adjusted HR of 90-day mortality was 2.49 (95% CI 1.27–4.87) in model 1 and 2.49 (95% CI 1.25–4.99) in model 2. When including only neoadjuvant-treated patients, those with preoperative stent had a 5-year survival of 39.2% compared to 46.4% without stent (adjusted HR 1.34, 95% CI 1.00–1.80), and a 90-day mortality rate of 8.5% and 2.5% (adjusted HR 3.99, 95% CI 1.51–10.50). Discussion: This nationwide study reports worse 5-year and 90-day outcomes in patients with preoperative esophageal stent. Since residual confounding remains possible, observed difference could be only an association rather than the cause.publishedVersionPeer reviewe

Metodityöskentely kuunnelman tuotantovaiheissa : Käsikirjoituksen kirjoittaminen ja muuttaminen äänikerronnaksi

Opinnäytetyönäni olen tutkinut erilaisia metodeja eli menetelmiä käsikirjoituksen kirjoittamiseksi ja sen saattamiseksi ääniksi ja äänikerronnaksi. Olen käsikirjoittanut kuunnelman ”Torin avajaiset”, jota olen erilaisin metodein muuttanut ääniksi, äänikerronnaksi ja lopulta valmiiksi kuunnelmaksi. Tarkoitukseni on tutkimuksella osoittaa, minkälaisia metodeja on käytettävissä. Mitä hyötyä eri metodeista on? Nopeuttavatko tai helpottavatko ne äänityksiä. Pohdin myös, muuttuuko käsikirjoitus prosessin aikana. Äänikerronnan ymmärtämisen helpottamiseksi käsikirjoituksesta on äänikerronta, ja erityisesti kohtauksien vaihdot, syytä tuoda visuaalisesti näkyviin paperille. Teippaamalla käsikirjoitus jonoksi ja suunnittelemalla äänet näkyviin käsikirjoituksen kylkeen, voidaan helpottaa kuunnelman rakenteen hahmottamista. Yksi menetelmistä on tehdä äänilista kohtaus kohtaukselta käsikirjoituksen mukaan, unohtamatta miellekarttoja. Koska kuunnelman äänittäminen autenttisessa ympäristössä ei useimmiten ole mahdollista, on yksi tapa äänittää kuunnelman vuorosanat ja miettiä ambienssia, tehosteita eli pisteääniä ja muuta ääninäyttämöä jälkitöiden aikana. Äänimaailmaan voidaan vaikuttaa eniten editointi-vaiheessa, jolloin kaikki lisäykset ovat mahdollisia. Tämä työ on tehty siten, että kaikki äänet on tehty ennen editointia ja ne on editointi-vaiheessa määritelty sopivan mittaisiksi, miksattu sopiville tasoille ja määritelty sopiville etäisyyksille.In my thesis I studied different methods of writing the script and converting it into sounds and audio narration. I wrote the script for a radio play “Torin avajaiset” which I converted by using different methods into sounds, audio narration and finally completed a radio play. My objective in this research is to show what kinds of methods are available and what the benefits of different methods are. The aim was to find out if the different methods speed up or facilitate the processes. This work also discusses if the script changes during the writing process. In order to facilitate understanding of the audio narration script in an audio narration and it is particularly important that the scene changes are visually displayed on paper. By taping the script into a sequence and by designing the script to appear on the side of the script can facilitate the visualization of the structure of a radio play. One of the methods is to make a sound list of the script scene by scene, in addition to mind maps. As an authentic recording of a radio play is not usually possible, one way is to record the lines according to the average of the month and think about ambience and other audio effects to the landscape during the post-work. The sound world can be most impacted on during editing process, during which all additions are possible. This work was done in such a way that all the sounds were made prior to editing and during the editing stage the length of sounds was bite-sized, mixed at the appropriate level and specified for suitable distances from each other

CrossBorder Shopping : ostosmatkailututkimus

CrossBorder Shopping -ostosmatkailututkimus on Kemi-Tornion ammattikorkeakoulun kesällä 2011 toteuttama tutkimus. Tutkimuksen kohteena oli Tornio-Haaparanta-alueella asioivat ihmiset ja heidän asiakaskokemukset. Tutkimuksen toteutti NorthRULL-hanke, jonka tavoitteena on edistää käyttäjiä osallistavaa Living Lab -toimintaa palvelujen ja innovatiivisten ratkaisujen tuottamisessa. NorthRULL on pohjois-suomalainen Living Lab -verkosto, jota koordinoi Kemi-Tornion ammattikorkeakoulu. CrossBorder Shopping -tutkimuskokonaisuus koostuu kesällä 2011 toteutetusta tutkimuksesta sekä tulosten hyödyntämisestä yhteiskehittämisessä syksyllä 2011. Tutkimuskokonaisuudesta tuotettiin tämä julkaisu, joka palvelee niin TKI ja Living Lab -toiminnasta kiinnostuneita kuin myös Meri-Lapin alueen yrityksiä, yhdistyksiä ja muita kehittämistoimijoita

Cohort profile : gastric cancer in the population-based, Finnish National Esophago-Gastric Cancer Cohort (FINEGO) Study

Purpose The Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established with the aim of identifying factors that could contribute to improved outcomes in oesophago-gastric cancer. The aim of this study is to describe the patients with gastric cancer included in FINEGO. Participants A total of 10 457 patients with gastric cancer or tumour diagnosis in the Finnish Cancer Registry or the Finnish Patient Registry during 1987-2016 were included in the cohort, with follow-up from Causes of Death Registry until 31 December 2016. All of the participants were at least 18 years of age, and had undergone either resectional or endoscopic mucosal surgery with curative or palliative intent. Findings to date Of the 10 457 patients, 90.1% were identified to have cancer in both cancer and patient registries. In all, the median age was 70 at the time of surgery, 54.5% of the patients were men and 64.4% had no comorbidities. Education data were available for 31.1% of the patients, of whom the majority had hadPeer reviewe

Histological assessment of stromal maturity as a prognostic factor in surgically treated gastric adenocarcinoma

Abstract Aims: Histological assessment of stromal maturity is a potential prognostic factor in colorectal cancer, but its applicability in gastric adenocarcinoma is completely unknown. The aim of this study was to evaluate the feasibility and prognostic significance of assessing stromal maturity in gastric adenocarcinoma. Methods and results: This study was conducted retrospectively in a cohort of 583 gastric adenocarcinoma patients treated surgically in Oulu University Hospital, Finland between 1983 and 2016. The original diagnostic slides were used for assessment of stromal maturity. Patients were divided into mature stroma and immature stroma groups, and stromal maturity was analysed in relation to 5‐year and overall survival (OS). The primary outcome of the study was 5‐year survival, and the secondary outcome was OS. The kappa‐coefficient for interobserver agreement was 0.609. Patients with immature stroma had worse 5‐year survival compared to patients with mature stroma [adjusted hazard ratio (HR) = 1.32, 95% confidence interval (CI) = 1.06–1.64]. Stromal maturity was significantly associated with 5‐year survival in intestinal‐type subgroup (adjusted HR = 0.63, 95% CI = 1.20–2.21), but not in the diffuse‐type subgroup (adjusted HR = 1.21, 95% CI = 0.87–1.70). Conclusions: Stromal maturity is an independent prognostic factor in gastric adenocarcinoma, and it can be analysed with moderate reproducibility