Objective. The study was performed to evaluate the results of treatment of ovarian carcinoma after the introduction of centralised primary surgery in the County of North Jutland, Denmark. Method. Prospective study of ...Objective. The study was performed to evaluate the results of treatment of ovarian carcinoma after the introduction of centralised primary surgery in the County of North Jutland, Denmark. Method. Prospective study of consecutive cases of ovarian cancer undergoing primary surgical treatment at the Gynecologic Oncologic Center after the introduction of centralised primary surgery. Results of treatment recorded up to the date of last examination or death. Results. From 1999 to 2002, 107 patients with primary epithelial ovarian cancer underwent primary surgery at the Gynecologic Oncologic Center, Aalborg. This corresponds to 95.5%of patients with invasive carcinoma in the County of North Jutland. All patients with Stage I to Stage IIIB disease had a complete, macroscopically radical cytoreduction performed. In patients with Stage III and IV invasive tumors, the optimal debulking rate was 79.5%, and, in Stage IIIC and IV, the optimal debulking rate was 78.2%. Intra-operative and post-operative complications were generally few. Post-operative death, defined as death within 30 days after surgery, was observed in 4 cases (3.7%). After primary surgery, platinum-based chemotherapy was given in most cases. For Stage I to IV invasive cancer, the median survival was 46 months. In patients with Stage IIIC and IV disease, the median survival was 32 months. In optimally debulked Stage IIIC and IV disease, the median survival was 41 months. Conclusions. The results in dicate a survival benefit after introduction of centralised primary surgery. Compared to existing national and regional data on survival in ovarian cancer, the results indicate an increase in median survival for all stages of approximately 15 months. Centralisation of primary surgery to centres with the necessary expertisemay be the most significant way to increase survival in ovarian cancer in Denmark.展开更多
Background: The incidence of acute myocardial infarction has declined in several Western countries during the last decades. The incidence and mortality of acute myocardial infarction follow a seasonal pattern. We exam...Background: The incidence of acute myocardial infarction has declined in several Western countries during the last decades. The incidence and mortality of acute myocardial infarction follow a seasonal pattern. We examined if changes in the incidence of acute myocardial infarction were associated with any changes in seasonality. Methods: The study was based on 17,989 patients hospitalized with first-time acute myocardial infarction identified in the Hospital Discharge Registry of the County of North Jutland, Denmark, from 1 January 1983 to 31 December 1999. The seasonality of acute myocardial infarction was estimated using a Poisson regression model. Results: The incidence rate decreased by 3.2%(95%confidence interval: 2.7-3.3%) annually. Hospitalizations followed different seasonal patterns depending on age, but not on gender. In the < 59-year-old group, the seasonal pattern was dominated by a broad spring peak(April/May) and a minor autumn peak. With increasing age, the spring peak decreased while the autumn peak increased and moved towards December. A seasonal pattern dominated by one peak(December) and one trough(August) was found in the ≥80-year-old category. The shape and extent of these seasonal patterns remained stable throughout the study period despite the decline in hospitalizations for acute myocardial infarction. Conclusion: Hospitalizations for first-time acute myocardial infarction decreased from 1983 to 1999, but the seasonal pattern remained stable over time.展开更多
文摘Objective. The study was performed to evaluate the results of treatment of ovarian carcinoma after the introduction of centralised primary surgery in the County of North Jutland, Denmark. Method. Prospective study of consecutive cases of ovarian cancer undergoing primary surgical treatment at the Gynecologic Oncologic Center after the introduction of centralised primary surgery. Results of treatment recorded up to the date of last examination or death. Results. From 1999 to 2002, 107 patients with primary epithelial ovarian cancer underwent primary surgery at the Gynecologic Oncologic Center, Aalborg. This corresponds to 95.5%of patients with invasive carcinoma in the County of North Jutland. All patients with Stage I to Stage IIIB disease had a complete, macroscopically radical cytoreduction performed. In patients with Stage III and IV invasive tumors, the optimal debulking rate was 79.5%, and, in Stage IIIC and IV, the optimal debulking rate was 78.2%. Intra-operative and post-operative complications were generally few. Post-operative death, defined as death within 30 days after surgery, was observed in 4 cases (3.7%). After primary surgery, platinum-based chemotherapy was given in most cases. For Stage I to IV invasive cancer, the median survival was 46 months. In patients with Stage IIIC and IV disease, the median survival was 32 months. In optimally debulked Stage IIIC and IV disease, the median survival was 41 months. Conclusions. The results in dicate a survival benefit after introduction of centralised primary surgery. Compared to existing national and regional data on survival in ovarian cancer, the results indicate an increase in median survival for all stages of approximately 15 months. Centralisation of primary surgery to centres with the necessary expertisemay be the most significant way to increase survival in ovarian cancer in Denmark.
文摘Background: The incidence of acute myocardial infarction has declined in several Western countries during the last decades. The incidence and mortality of acute myocardial infarction follow a seasonal pattern. We examined if changes in the incidence of acute myocardial infarction were associated with any changes in seasonality. Methods: The study was based on 17,989 patients hospitalized with first-time acute myocardial infarction identified in the Hospital Discharge Registry of the County of North Jutland, Denmark, from 1 January 1983 to 31 December 1999. The seasonality of acute myocardial infarction was estimated using a Poisson regression model. Results: The incidence rate decreased by 3.2%(95%confidence interval: 2.7-3.3%) annually. Hospitalizations followed different seasonal patterns depending on age, but not on gender. In the < 59-year-old group, the seasonal pattern was dominated by a broad spring peak(April/May) and a minor autumn peak. With increasing age, the spring peak decreased while the autumn peak increased and moved towards December. A seasonal pattern dominated by one peak(December) and one trough(August) was found in the ≥80-year-old category. The shape and extent of these seasonal patterns remained stable throughout the study period despite the decline in hospitalizations for acute myocardial infarction. Conclusion: Hospitalizations for first-time acute myocardial infarction decreased from 1983 to 1999, but the seasonal pattern remained stable over time.
