Annals of Oncology 2007 18(3):405; doi:10.1093/annonc/mdm067
© 2007 European Society for Medical Oncology
in this issue
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Cancer incidence and mortality in Europe in 2006
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In 2005 Boyle and Ferlay produced estimates of cancer incidence
and mortality in Europe for the year 2004 using the most recent
sources of cancer data available at that time, applied to population
projections. In this issue,
Ferlay et al. present updates of
those figures, with the aim of providing estimates of the incidence
of and mortality from eighteen cancers in thirty-nine European
countries in 2006, using the most recent incidence and mortality
data available and short-term predictions methods and to monitor
the evolution of the cancer burden in Europe. These authors
conclude that the total number of new cases of cancer in Europe
appears to have increased by 300,000 since 2004. With an estimated
3.2 million new cases (53% occurring in men, 47% in women) and
1.7 million deaths (56% in men, 44% in women) each year, cancer
remains an important public health problem in Europe and the
ageing of the European population will cause these numbers to
continue to increase even if age-specific rates remain constant.
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Second conservative approach for ipsilateral breast tumour recurrence
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While breast conservation is considered the treatment of first
choice for early breast cancer worldwide, with a similar long-term
outcome to mastectomy, a minority of patients so treated will
develop ipsilateral breast tumour recurrence (IBTR). So far
the vast majority of such women have undergone mastectomy, thus
frustrating the objective of conservative surgery. However,
many women are diagnosed with small and early detected IBTR,
which might be managed with a new conservative procedure. In
this issue,
Gentilini et al. report a study that aimed to retrospectively
evaluate prognosis of patients with IBTR after breast conservation
who were treated by second conservative surgery, to determine
whether any predictive factors of outcome could be identified,
and to select the subset of patients who are the best candidates
for a second conservative approach. These authors conclude that
some patients with IBTR might receive a second breast-conserving
surgery, especially when a good local control can be estimated
(small recurrent tumour, late relapse), and they suggest that
that the occurrence of IBTR should not be considered
per se a failure of the conservative approach.
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Post-remission intensive therapy in patients with acute leukemia
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In the last decade, the standard approach to the young patient
with acute myelogenous leukemia (AML) has been adjusted towards
risk-adapted post-remission therapy, that is high-dose arabinoside
(HiDAC)-based therapy for those at favorable risk and allogeneic
stem cell transplantation for those with unfavorable cytogenetics.
However, the best post-remission therapy for AML patients with
either intermediate or unknown cytogenetic risk is still controversial.
In this issue,
Yu et al. present the results of a study that
aimed to assess the cost-effectiveness of HiDAC-based and allogeneic
stem cell transplantation-based therapy in patients with acute
leukemia. These authors report that ost-effectiveness analysis
showed the mean cost per year of life saved for the HiDAC-based
therapy is considerably less expensive than the alloSCT-based
therapy (USD 11,224 versus 21,564). They conclude that for the
post-remission therapy of young AML patients at either intermediate
or unknown cytogenetic risk, the cost-effectiveness of HiDAC-based
therapy compares favorably with that of allogeneic stem cell
transplantation-based therapy, which deserves further clinical
trials.
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Detecting circulating tumor cells in blood of patients with prostate cancer using telomerase activity
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Progression of prostate cancer to metastases involves a series
of molecular and physical events that result in the destruction
of the extracellular matrix, intravasation, circulating tumor
cells (CTC) in the blood, extravasation, and eventually deposition
at and proliferation to target sites, and especially bones.
Detecting CTC after definitive local therapy may have an impact
on apparently localized prostate cancer by allowing better selection
of patients for systemic treatments. In this issue,
Fizazi et al. report on a method based on telomerase activity which was able
to detect CTC with a high sensitivity and excellent specificity
in a series of 107 patients with prostate cancer at various
disease stages. These authors suggest that potential applications
of this method for detecting CTC using telomerase activity in
prostate cancer patients may include early diagnosis, prognosis
assessment in localized disease, treatment monitoring, and that
this may be an easier way to obtain tumor material rather than
performing bone biopsies in patients with metastases.
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Quote
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"The
courage, of which I have spoken, so necessary in the case
of washing the children in spite of their screaming remonstrances,
is, if possible, more necessary in cases of illness, requiring
the application of
medicine, or of
surgical means of cure. Here
the heart is put to the test indeed!"
Advice to Young Men. And (Incidentally) to Young Women in the Middle and Higher Ranks of Life from William Cobbett
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Related articles in Ann Oncol:
- Estimates of the cancer incidence and mortality in Europe in 2006
- J Ferlay, P Autier, M Boniol, M Heanue, M Colombet, and P Boyle
Ann Oncol 2007 18: 581-592.
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- When can a second conservative approach be considered for ipsilateral breast tumour recurrence?
- O Gentilini, E Botteri, N Rotmensz, B Santillo, N Peradze, RC Saihum, M Intra, A Luini, V Galimberti, A Goldhirsch, and U Veronesi
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Cancer incidence and mortality...
Second conservative approach for...