OBJECTIVE To determine the possibly greater occurrence of multiple malignancies in patients with renal cell carcinoma (RCC). PATIENTS AND METHODS In the 7‐year period 1987–93, all 1425 patients aged 15–70 years with registered histopathologically verified RCC in Norway were included in the study. All clinical and histopathology reports were checked manually, to verify the registered diagnosis and to ensure that no tumour was a metastasis from another. After this process, 257 patients (287 tumours other than RCC) with multiple primary malignancies were identified. The primary tumours other than RCC were classified as antecedent, synchronous and subsequent. For the subsequently occurring tumours, the expected number of different tumour types was calculated according to age group, gender and observation time. RESULTS Of the 1425 patients, 228 (16%) had one, 23 (1.6%) had two, three (0.2%) had three and one (0.07%) had four other primary malignancies. In all, 100 (34.8%) of the other tumours were diagnosed as antecedent, 53 (18.7%) as synchronous and 134 (46.7%) as subsequent to the RCC. Cancer in the prostate, bladder, lung, breast, colon and rectal cancer, malignant melanomas (MM) and non‐Hodgkin's lymphomas (NHL) were the most common other malignancies. The observed overall number of subsequent other malignant tumours was 22% higher than the expected number. The observed number of subsequent tumours was significantly higher for bladder cancer, NHL and MM. The estimated 15‐year cumulative risk for patients with RCC and no previous or synchronous other malignancy for developing a later second cancer was 26.6% in men, and 15.5% in women (statistically significant, P = 0.04). Patients with antecedent or synchronous other cancer had significantly poorer overall survival than those without. CONCLUSIONS Patients with RCC seem to have a significantly higher risk of developing other subsequent primary malignancies. This should be considered during the follow‐up of patients with RCC.
The aim of the present study is to describe the development in the use of breast-conserving surgery and sentinel node procedures in Norway from 1993 to 2001, with special emphasis on geographical variations and possible relationships with the mammography screening programme.The Cancer Registry of Norway registers diagnosis and treatment of all cases of cancer in Norway. All women diagnosed with breast cancer in the period 1993-2001 who received surgical treatment were included in the study except those with distant metastases at diagnosis.During the period, there were 18,564 surgically treated female breast cancer patients without evidence of distant metastases. Breast-conserving surgery was applied in 4203 (22%) out of 19,408 cases. The proportion increased from 14% in 1993 to 36% in 2001. In most counties with mammography screening, the proportion of breast-conserving surgery in women aged 50-69 rose to 40% or more in 2001. Utilisation of sentinel node biopsy in breast-conserving surgery increased from 2% in 1998 to 55% in 2001.Over the 1993-2001 period, there was a strong increase in the extent of utilisation of breast-conserving surgery and sentinel node biopsy in breast cancer in Norway.
Surgical resection for lung cancer is the mainstay of curative treatment, but studies regarding postoperative results and long term outcome in the elderly have differed. The purpose of the present study was to assess the early and long-term results of surgical resection in patients more than 70 years of age.In Norway all clinical and pathologic departments submit reports on cancer patients to the Cancer Registry of Norway. This investigation included all patients more than 70 years of age resected for lung cancer in the time period 1993-2000. For results of long-time follow-up only patients operated on between 1993 and 1998 were included.A total of 763 patients (541 men) were identified aged 71-87 years. Postoperative mortality rate was 9%, highest after bilobectomy and pneumonectomy. The most commonly reported causes of postoperative death were pneumonia and cardiac complications. The majority of patients had tumor categorized as clinical stage (cStage) Ia and Ib. More than 100 in each of these groups proved to have more advanced disease postoperatively (pStage). The 5-year relative survival rate was significantly better in patients with disease in pStage I compared to higher stages. Women had a significantly better 5-year survival rate compared to men, 62.8 and 35.7%, respectively.Lung cancer surgery appears to be a relatively safe procedure even in the elderly. There is a high postoperative mortality after bilobectomy and pneumonectomy. However, when old people survive the postoperative period the long term prognosis seems favorable.
Objective: The postoperative mortality following lung cancer surgery is relatively high. The purpose of the present study was to identify preoperative risk factors as well as fatal complications in 27 Norwegian hospitals. Methods: In Norway, all clinical and pathologic departments submit reports on cancer patients to the Cancer Registry of Norway. The Registry also has a law-regulated authority to collect supplemental information regarding diagnosis, treatment, and outcome for all cancer patients from the hospitals in charge. This investigation included all patients who died within 30 and 60 days after resection of lung cancer in the period 1993–2002. Results: During the investigation lung cancer was diagnosed in 19,582 patients, 3224 (16.5%) were treated by surgery. The resection rate was almost similar in the two sexes, but postoperative mortality in women was less than half compared to men. Total mortality was 5% and 8% after 30 and 60 days, respectively. Bilobectomy and pneumonectomy were most risky with a mortality rate of about 10% within 60 days. In patients more than 70 years of age, there was a considerably higher frequency of pneumonectomy in men compared to women. Dominating causes of death were pneumonia with respiratory failure and cardiac events. Other identifiable causes were surgical hemorrhage and bronchopleural fistula. Conclusions: In this population-based, unselected series, the postoperative mortality was relatively high, and increased markedly in patients older than 70 years. Pneumonectomy in patients older than 70 years should only be performed when heart–lung function is found to be acceptable following full pulmonary function testing and thorough preoperative assessment of cardiovascular risk factors.
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