With a recently developed statistical technique based on combinatorial methods/ cases of leukemia and lymphoma diagnosed among Connecticut residents during 1945–59 were tested for the presence of 1- and 2-year clusters within towns. The method had previously been found very powerful in detecting the case-clustering of poliomyelitis and infectious hepatitis. The leukemia cases, both childhood and all ages, showed no tendency to occur in 1- or 2-year clusters. The lymphoma (all ages) cases tended to cluster. When cases of leukemia and lymphoma were combined as if they had a common etiology, a result consistent with a hypothesis of no clustering was obtained.
A series of 270 patients with Hodgkin's disease, diagnosed between July 1953 and July 1968, and classified according to the Lukes-Butler histologic classification scheme, is used to illustrate two statistical procedures for evaluating the simultaneous effect of various prognostic factors. The results are presented as equations in which median years of survival depend jointly on histologic type, sex, stage of disease, and symptoms at diagnosis. The data included in this report are sufficient for illustrating the statistical methods, although a much larger series of Hodgkin's disease patients would be required for carrying out an analysis of this type that would provide valid results for survival prediction.
Abstract In a retrospective cohort study of 47 Wilms' tumor survivors and their 77 sibling controls, female survivors had a fourfold excess risk (risk ratio, 4.1; 95% confidence interval, 1.7‐10.1) for any adverse livebirth outcome, including birth defects, compared with their sibling controls. Wives of male survivors had no apparent excess risk for problem pregnancies. The families had a number of severe reproductive problems and major birth defects, such as primary amenorrhea in two survivors, bicornuate uterus in two survivors and one control, and mental retardation in one male survivor and a male control. The son of a female survivor died after bilateral Wilms' tumors. Birth defects in the offspring of female survivors are compatible either with intrauterine constraint, possibly due to radiation‐induced fibrosis or with the complex of malformations associated with Wilms' tumor. Female survivors of Wilms' tumor appear to be at increased risk for a variety of reproductive problems, from sterility to fetal loss, early delivery, and birth defects in offspring. Furthermore, relatives of survivors of Wilms' tumor may be at risk of having associated birth defects, with clinically significant consequences.
Among tumors of the lung, main stem bronchial cancer offers a particularly unfavorable prognosis, probably because of its rapid extension to the segmental bronchi, trachea, and extrapulmonary structures. However, analysis of data gathered by the End Results Group indicates that survival among those patients with main stem bronchial cancer whose tumor was resected was virtually the same as that of patients with resectable lung cancer of other sites. From these data it is impossible to assess what role, if any, the resection itself played, and a randomized trial would be necessary to determine whether resection improves the probability of patient survival. On the other hand, it is not now advisable to deny resection to patients with operable main stem bronchial tumors (except oat cell tumors) on the basis of the available nonexperimental evidence alone.
Hyman, B., M. H. Myers and D. Schottenfeld (Clin. Epidem. and Stat, Memorial Hosp. for Cancer and Allied Diseases, New York, N.Y. 10021). The relationship of menstrual status and other risk factors to recurrence of carcinoma of the breast. Am J Epidemiol 96: 173–182, 1972.—In this review of 491 women 45–59 years of age, axillary nodal status and primary cancer size were important prognosticators of the duration of the disease-free interval after radical mastectomy. The probability of escaping recurrent disease at five years was 83% for patients with no axillary nodal involvement, 62% for patients with a single level of nodal involvement and 32% for patients with involvement at multiple levels. Similarly, for patients with tumors 2.0 cm or less in greatest diameter, the probability of escaping recurrence at five years was 80%; the corresponding rate for tumors 2.1 to 5.0 cm was 56% and for tumors greater than 5.0 cm, 30%. For each nodal category, increasing tumor size accelerated the average time to recurrence. Histologic differentiation of the tumor was less discriminating than tumor size. The probability of surviving five years without recurrent disease was 68% for Grade II (more differentiated) tumors and 54% for Grade III (less differentiated) tumors. In reviewing the relationship between menstrual status at the time of radical mastectomy and the probability of recurrence, we noted that patients who were artificially postmenopause, as compared with those who were actively menstruating or naturally postmenopause, had smaller tumors, less axillary nodal involvement and demonstrated an advantage with respect to escape from recurrent cancer. The probability of surviving five years without recurrent cancer was 72% for patients artificially postmenopause; for those patients who were actively menstruating at the time of radical mastectomy, the probability of escaping recurrent disease at five years was 56%, and for those patients who were naturally postmenopause, 55%. There was no significant difference in the probability of escaping recurrent disease between those patients who were surgically castrated or had ovarian irradiation one or more years prior to radical mastectomy (66%) and those with hysterectomy without reporting bilateral oophorectomy (74%). Analysis of the joint effects of menstrual status, axillary node involvement, tumor size and histologic grade indicated that no particular menstrual category was uniformly superior with respect to the probability of escaping recurrence.
The impact of cancer on persons 65 years of age and older has been assessed by examining incidence rates and survival rates. For all cancers combined, the incidence rate shown in Table 4 for males 65 and older (2,468.2 per 100,000) is four times the age-adjusted rate for males 45 to 64 years of age (586.7). For elderly females, the incidence rate is twice that for females aged 45 to 64 (1,401.1 versus 609.7). Ratios of incidence rates for older versus younger males are about four to five for cancers of the stomach, colon, rectum, pancreas, and urinary bladder, and for leukemia; about three for cancers of the lung and kidney, and for non-Hodgkin's lymphomas; and 10 for cancer of the prostate. For females, the corresponding ratios are similar to those for males, although a little lower for cancers of the colon, rectum, and urinary bladder, and for leukemia, and a little higher for cancers of the stomach and pancreas. The ratios for breast, uterine cervix, uterine corpus, ovary, and lung are less than two. The relative survival rates for patients 65 and older are for many cancer sites only a few percentage points lower than rates for those 45 to 64 years of age (Table 5), suggesting that patients in this age group fare only a little worse than younger patients in escaping the effects of cancer once it has been diagnosed. Exceptions are cancer of the urinary bladder and non-Hodgkin's lymphomas for both men and women and cancers of the uterine cervix, uterine corpus, ovary, and kidney for women. For these sites, the survival rates for older patients are considerably lower than for their younger counterparts. For female breast cancer patients, there was no difference in the five-year relative survival rate for those 65 and older compared with those 45 to 64.
Signals measured by electroencephalogram (EEG) arrays were decomposed using Hubert Transformations to produce the spatial amplitude and phase modulation (AM and PM) patterns. Spatial PM patterns intermittently exhibit synchronization-desynchronization transitions. During desynchronization, the spatial PM patterns intermittently conform to conic shapes. These phase cones mark the onset of emergent AM patterns, which carry cognitive content. In this work, various temporal band pass filters were applied to study the frequency dependence of phase cones in the beta-gamma range (10-40 Hz). The results are interpreted in the context of the cognitive cycle of knowledge generation.
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