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  • 1.
    Norlén, Olov
    et al.
    Uppsala universitet, Endokrinkirurgi.
    Edfeldt, Katarina
    Uppsala universitet, Endokrinkirurgi.
    Åkerström, Göran
    Uppsala universitet, Endokrinkirurgi.
    Westin, Gunnar
    Uppsala universitet, Endokrinkirurgi.
    Hellman, Per
    Uppsala universitet, Endokrinkirurgi.
    Björklund, Peyman
    Uppsala universitet, Endokrinkirurgi.
    Stålberg, Peter
    Uppsala universitet, Endokrinkirurgi.
    Peritoneal carcinomatosis from small intestinal neuroendocrine tumors: Clinical course and genetic profiling2014In: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 156, no 6, p. 1512-1522Article in journal (Refereed)
    Abstract [en]

    Background. One-fifth of all patients with small-intestinal neuroendocrine tumors (SI-NETs) present with or develop peritoneal carcinomatosis (PC). Our aim was to determine the prognosis and genetic profiles of tumors in patients with PC compared with tumors in patients without PC. Methods. We included SI-NET patients (cases with PC, n = 73, and controls without PC, n = 468) who underwent operation between 1985 and 2012. The Lyon prognostic index was used to correlate the amount of PC to survival. DNA samples from patients with (n = 8) and without (n = 7) PC were analyzed with a single-nucleotide polymorphism array (HumanOmni2.5 BeadChip, Illumina) to investigate genetic disparities between groups. Results. Patients with PC had poorer survival (median 5.1 years) than controls (11.1 years). An advanced postoperative Lyon prognostic index was a negative prognostic marker for survival by multivariable analysis (P = .042). Patients with and without PC clustered differently based on loss of heterozygosity and copy number variation data from single-nucleotide polymorphism array of the primary tumors (P = .042). Conclusion. SI-NET patients with PC have poor survival, which diminishes with increasing PC load after surgery. Clustering based on copy number variation and loss of heterozygosity data suggests different genotypes in primary tumors comparing patients with and without PC.

  • 2.
    Strömberg, Lars
    Red Cross University College of Nursing.
    Omvårdnad av patienter med ortopediska sjukdomar2012In: Omvårdnad vid kirurgiska sjukdomar / [ed] Lillemor Lindwall, Lund: Studentlitteratur AB, 2012, 1, p. 113-128Chapter in book (Other academic)
  • 3.
    Wennman-Larsen, Agneta
    et al.
    Karolinska Institutet.
    Petersson, Lena-Marie
    Karolinska Institutet.
    Saboonchi, Fredrik
    Karolinska Institutet.
    Alexanderson, Kristina
    Karolinska Institutet.
    Vaez, Marjan
    Karolinska Institutet.
    Consistency of Breast and Arm Symptoms During 
the First Two Years After Breast Cancer Surgery2015In: Oncology Nursing Forum, ISSN 0190-535X, E-ISSN 1538-0688, Vol. 42, no 2, p. 145-155Article in journal (Refereed)
    Abstract [en]

    Purpose/Objectives: To examine the severity and development of breast and arm symptoms separately during the two years following breast cancer surgery, and to examine whether previously defined predictors of arm symptoms are associated with breast symptoms.


    Design: Prospective cohort study with two-year follow-up. 


    Setting: Three institutions in the Stockholm, Sweden, region.


    Sample: 645 women, aged 20–63 years, enrolled within 12 weeks of surgery for primary breast cancer. 


    Methods: Baseline register and questionnaire data with five follow-ups were submitted to descriptive, inferential, and logistic regression analysis.


    Main Research Variables: Severity of breast and arm symptoms measured by the European Organisation for Research and Treatment of Cancer breast cancer–specific quality-of-life questionnaire.


    Findings: Most participants had undergone breast-conserving 
surgery and sentinel lymph node dissection, and were scheduled for postoperative radiation therapy. Overall mean levels of breast and arm symptoms were low, but with large individual variations. At all six time points, the mean levels of breast symptoms were significantly higher than those of arm symptoms. Overall, the mean level of both types of symptoms decreased during follow-up. A body mass index (BMI) of 25 or greater and breast symptoms at eight months were associated with having breast symptoms at two years. Arm symptoms at baseline and at eight months, and radiation therapy and a BMI of 25 or greater were associated with having arm symptoms at two years.


    Conclusions: Breast symptoms show different patterns of change and are not associated with the same factors as arm symptoms.


    Implications for Nursing: For nurses monitoring women treated for breast cancer, the results of this study provide knowledge regarding the importance of early symptom identification and long-term symptoms after treatment.

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