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  • 1. du Bois, A
    et al.
    Quinn, M
    Thigpen, T
    Vermorken, J
    Avall-Lundqvist, E
    Bookman, M
    Bowtell, D
    Brady, M
    Casado, A
    Cervantes, A
    Eisenhauer, E
    Friedlaender, M
    Fujiwara, K
    Grenman, S
    Guastalla, JP
    Harper, P
    Högberg, Thomas
    NSGO (Scandinavia).
    Kaye, S
    Kitchener, H
    Kristensen, G
    Mannel, R
    Meier, W
    Miller, B
    Neijt, JP
    Oza, S
    Ozols, R
    Parmar, M
    Pecorelli, S
    Pfisterer, J
    Poveda, A
    Provencher, D
    Pujade-Lauraine, E
    Randall, M
    Rochon, J
    Rustin, G
    Sagae, s
    Stehman, F
    Stuart, G
    Trimble, E
    Vasey, P
    Vergote, L
    Verheijen, R
    Wagner, U
    2004 consensus statements on the management of ovarian cancer: final document of the 3rd International Gynecologic Cancer Intergroup Ovarian Cancer Consensus Conference (GCIG OCCC 2004)2005In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 16, no supplement 8, p. 36-38Article in journal (Refereed)
  • 2. Glimelius, Bengt
    et al.
    Bergh, Jonas
    Brandt, Lars
    Brorsson, Bengt
    Gunnars, Barbro
    Hafström, Larsolof
    Haglund, Ulf
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Janunger, Karl-Gunnar
    Jönsson, Per-Ebbe
    Karlsson, Göran
    Kimby, Eva
    Lamnevik, Gunilla
    Nilsson, Sten
    Permert, Johan
    Ragnhammar, Peter
    Sörenson, Sverre
    Nygren, Peter
    The Swedish Council on Technology Assessment in Health Care (SBU) systematic overview of chemotherapy effects in some major tumour types - summary and conclusions.2001In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 40, p. 135-154Article in journal (Refereed)
  • 3.
    Högberg, Thomas
    Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Ovarian cancer: Treatment results, prognostic factors, and tumor marker surveillance1992Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The total population-based material of 426 ovarian malignancies in the Southeast Health Care Region of Sweden during 1984-1987 was surveyed. It seems that with a program of cytoreductive surgery followed by a cisplatinum chemotherapy combination in the metastasizing cases the overall survival figures have improved. A relative overall 5-year survival of 43% was recorded. Age and stage were independent prognostic factors for survival, while histology (epithelial vs, non-epithelial tumors) did not add prognostic information.

    384 patients with ovarian carcinomas were analyzcd separately. An overall relative survival of 40% was recorded. Tite overall corrected 5-yearsurvival for patients prescribed protocol treatment was 49 % compared to 33 % for those treated otlJCrwise. The corrected 5-year survival for patients with FIGO stage Ill -IV tumorswas 35 % if optimal primary cy~oreductive surgery wasperfonned.Patientswith residual tumors greater than 1cm had 13% corrected5-yearsurvival. Patients that underwent intestinal surgery as a part of initial surgical debulking had a very poor survival, even compared with 1l1e group of patients with greater than 3 cm residual tumors left after initial surgery ( 4 vs. 13 %). The secondary laparotomy gave prognostic information only in stages I and ll. Eighteen of 68 patients (26 %) who had macroscopic turn or left at the secondary surgery cmdd be rendered tumor free at the secondary laparotomy. This group had about the same survival as those who were foi.Uld to be in complete response at the secondary laparotomy. It was not possible to ~iatc that this was caused by the ~urgeryper se.

    Geometrical measurements oftumor nuclei on the diagnostic tissue sections generated powerful prognostic factors for survival after secondary laparotomy in 65 patients with advanced ovarian cancer. The existence of very large nuclei seemed to cl1aracterize patients with a bad prognosis.

    The half-life of the turn or marker CA 125 in serum during induction chemothrapy gave equally good prognostic information regarding the survival after secondary laparotomy in 72 patients with advanced ovarian cancer as registering the response to therapy at the secondary laparotomy.

    In 33 ovarian cancer patients monitoring with monthlyscrum CA 125 determinations during follow-up was a reliable method to diagnose a recurrence with very few (0.9%) false positive values.

  • 4.
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Tubarligation för att förebygga ovarialcancer hos kvinnor med gentisk disposition.2001In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 98, p. 3929-3929Article in journal (Other academic)
  • 5.
    Högberg, Thomas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Fredstorp-Lidebring, M
    Alm, P
    Baldetorp, B
    Larsson, G
    Ottosen, C
    Svanberg, L
    Lindahl, B
    A prospective population-based management program including primary surgery and postoperative risk assessment by means of DNA ploidy and histopathology. Adjuvant radiotherapy is not necessary for the majority of patients with FIGO stage I-II endometrial cancer2004In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 14, no 3, p. 437-450Article in journal (Refereed)
    Abstract [en]

    A management program for FIGO stage I-II nonserous, nonclear-cell adenocarcinomas was evaluated. Histopathology and DNA ploidy were used to estimate postoperatively the risk of progression or death of disease and to tailor treatment. The patient material was a population-based consecutive cohort of all women with endometrial cancer in the Southern Swedish Health Care Region diagnosed between June 1993 and June 1996 (n=553). Of these, 335 were eligible for the management program. Patients estimated to be at low risk were treated by surgery only, while high-risk patients also received vaginal brachytherapy. A large low-risk group consisting of 84% (n=283) of the patients with an estimated disease-specific 5-year survival of 96% (95% CI=93-98%) was identified. The high-risk group (n=52, 16%) showed a worse outcome with an 80% 5-year disease-specific survival (95% CI=65-89%). The difference in survival between the groups was highly significant (P<0.0001). Half of the progressions were distant in the high-risk group. Although there is a clear indication for adjuvant therapy for this group, locoregional radiotherapy could be expected to fail in cases with distant progression. Thus, effective systemic treatments need to be developed. Low-risk patients, constituting the majority (84%) of the patients, can be safely treated by surgery only.

  • 6.
    Högberg, Thomas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Glimelius, Bengt
    Nygren, Peter
    A systematic overview of chemotherapy effects in ovarian cancer2001In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 40, no 2-3, p. 340-360Article in journal (Refereed)
    Abstract [en]

    A systematic review of chemotherapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for the evaluation of the scientific literature are described separately (Acta Oncol 2001, 40: 155-65). This overview on chemotherapy for epithelial ovarian cancer is based on a total of 176 scientific reports. Five meta-analyses including 17 291 patients, 33 prospective randomised studies including 12 340 patients, 36 prospective studies including 3593 patients and one retrospective study including 421 patients. The studies include approximately 33 642 patients. The conclusions reached can be summarized into the following points: ò Radically operated patients with low-risk early ovarian cancer (stage IA or IB non-clear-cell well-differentiated carcinomas or borderline tumours) have a very good prognosis and there is no indication for adjuvant therapy. ò Radically operated patients with high-risk early ovarian cancer (clear cell carcinomas or FIGO stage IA or IB moderately or poorly differentiated carcinomas or stage IC) have a substantial risk for micrometastatic disease. However, the role of adjuvant chemotherapy is unclear and such therapy should, thus, only be used within clinical trials. ò The median overall survival for patients with advanced (FIGO stages II-IV) ovarian cancer randomised to paclitaxel/platinum-containing chemotherapy in three large studies ranged between 36-39 months. Compared with historical data, this represents a six to seven times longer median survival time than after surgery only. The probability for long-term survival for patients treated with a paclitaxel/platinum combination is too early to define. ò In two prospective randomised trials in advanced ovarian cancer, paclitaxel in combination with cisplatin has provided a survival benefit over cyclophosphamide/cisplatin. Based on these trials, paclitaxel/cisplatin is considered to be the standard treatment. ò This choice of standard therapy might, however, be questioned based on the results of the hitherto largest randomised study in advanced ovarian cancer, ICON3, which is, as yet only available in abstract form. It compared paclitaxel/carboplatin with carboplatin only or a platinum combination (cyclophosphamide/doxorubicin/cisplatin). There were no statistically significant differences in progression-free or overall survival. The drug regimen in the control arms of the previous studies showing superiority of the paclitaxel-cisplatin combination may not have been the optimal non-paclitaxel platinum-containing regimen. ò Three randomised studies have compared carboplatin/paclitaxel with cisplatin/paclitaxel. All three are hitherto only published as abstracts with short follow-up precluding survival analyses. None of them shows any difference in response rates. All three show less toxicity and one also better quality of life with carboplatin. Thus, there are preliminary data supporting the substitution of cisplatin with carboplatin. ò Intraperitoneal therapy with cisplatin caused improved survival compared with intravenous therapy in one ramdomised study. Further studies have shown trends to better survival and longer progression-free interval with intraperitoneal therapy. The accrual to studies on intraperitoneal chemotherapy has been poor reflecting that it is a cumbersome and not easily accepted treatment. ò In advanced ovarian cancer, no convincing advantage has been shown from more dose-intensive chemotherapy, without cytokines or bone marrow stem cell support, compared with standard doses. ò High response rates are achieved with high-dose chemotherapy with stem cell support in the salvage situation but response duration is short. Phase III studies evaluating high-dose chemotherapy in the first-line situation are ongoing. Until supportive controlled clinical trials are presented, high-dose chemotherapy should be confined to clinical trials. ò Tumour response is frequently observed on re-treatment with the same drugs as given first-line in patients sensitive to first-line platinum-based chemotherapy with a long progression-free interval. Thus, in these patients treatment with a platinum/ paclitaxel combination might be recommended, albeit based on limited data. In patients resistant to first-line therapy, a number of single agents induce tumour responses in the range of 10-30%. The literature does not permit general treatment recommendations in these patients, which are recommended to be included in controlled clinical trials.

  • 7.
    Högberg, Thomas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Rosenberg, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Role of weekly paclitaxel in the treatment of advanced ovarian cancer2002In: Critical reviews in oncology/hematology, ISSN 1040-8428, E-ISSN 1879-0461, Vol. 44, no SUPPL.Article in journal (Refereed)
    Abstract [en]

    Dose-dense weekly administration of paclitaxel has the potential advantage of allowing a larger percentage of cancer cells to enter the vulnerable phase of their cell cycle when cytotoxic paclitaxel concentrations are present. The lower doses and shorter infusion times used with weekly dosing should also minimize bone marrow suppression and other toxicities associated with standard paclitaxel 3-weekly administration. Clinical studies have confirmed that paclitaxel can be safely delivered on a weekly schedule as a 1-h infusion to patients with advanced ovarian cancer. Weekly administration of paclitaxel also appears to be better tolerated than 3-weekly administration. Single-agent weekly paclitaxel is associated with response rates of 20-65%. Combination therapy with weekly paclitaxel has mainly involved carboplatin and response rates with such regimens range from 60-88%. Triple-drug combination therapy has produced response rates of 42-67.5%. Such therapy has included weekly paclitaxel in combination with carboplatin/cisplatin plus topotecan, and carboplatin plus doxorubicin. In an attempt to avoid problems with high corticosteroid doses, dexamethasone doses of 10 and 8 mg have been used successfully in premedication regimens for weekly paclitaxel in ovarian cancer. ⌐ 2002 Elsevier Science Ireland Ltd. All rights reserved.

  • 8. Koul, A
    et al.
    Bendahl, P-O
    Borg, Å
    Fernö, M
    Fredstorp Lidebring, M
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Långström Einarsson, M
    Ridderheim, M
    Willén, R
    TP53 protein expression analysis by luminometric immunoassay in comparison with gene mutation status and prognostic factors in early stage endometrial cancer2002In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 12, no 4, p. 362-371Article in journal (Refereed)
    Abstract [en]

    Mutations in the TP53 tumor suppressor gene have been shown to significantly correlate with poor prognosis in endometrial cancer. In the present study we have evaluated a luminometric immunoassay (LIA) for quantitative estimation of TP53 protein expression in 65 cytosol preparations from endometrial cancer, previously analyzed for mutations in TP53 exons 4-10. LIA showed high (= 0.6 ng/mg protein) expression of TP53 protein in all eight tumors with missense mutation, but high protein levels were also detected in 15 tumors with normal TP53 sequence. All four tumors with nonsense or frameshift mutations had low or no TP53 protein expression. LIA was further evaluated in a retrospective study of 201 cytosol samples from endometrial cancer. TP53 overexpression (>= 0.6 ng/mg protein) was observed in 22% of the tumors and correlated with nonendometrioid histology types (P = 0.005), poorly differentiated tumors (P = 0.001), higher FIGO grade (P = 0.001), DNA nondiploidy (P = 0.002), and high S-phase fraction (P = 0.03). After a median follow-up time of 6.8 years (range 0.7-9.9 years), 22 (13%) progressions were observed in the 175 patients with early stage (I-II) disease. TP53 overexpression (P = 0.04), FIGO grade 3 vs. 1 + 2 (P = 0.01), higher age (P = 0.02), and DNA nondiploidy (P < 0.001) showed significant correlation to shorter progression-free survival in these patients. We conclude that TP53 protein analysis by LIA provides an incomplete correlation to mutation status and cannot substitute for mutation analysis in assessment of prognosis in endometrial carcinoma. In comparison to TP53 overexpression and higher FIGO grades, DNA nonploidy status seems to be a better prognostic indicator to define a subset of early stage endometrial cancer patients who may benefit by adjuvant chemotherapy/radiotherapy.

  • 9.
    M Del Campo, J
    et al.
    Vall Hebron University Hospital.
    Roszak, A
    Wielkopolska Oncol Centre.
    Bidzinski, M
    Maria Sklodowska Curie Mem Canc Centre.
    Ciuleanu, T E
    Ion Chiricuta Canc Institute.
    Högberg, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Oncology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Wojtukiewicz, M Z
    Med University, Comprehens Canc Centre Bialystok.
    Poveda, A
    Valencian Institute Oncol.
    Boman, K
    Umeå University Hospital.
    Westermann, A M
    University of Amsterdam.
    Lebedinsky, C
    PharmaMar Clin R&D.
    Phase II randomized study of trabectedin given as two different every 3 weeks dose schedules (1.5 mg/m(2) 24 h or 1.3 mg/m(2) 3 h) to patients with relapsed, platinum-sensitive, advanced ovarian cancer2009In: ANNALS OF ONCOLOGY, ISSN 0923-7534, Vol. 20, no 11, p. 1794-1802Article in journal (Refereed)
    Abstract [en]

    Patients and methods: Patients previously treated with less than two or two previous chemotherapy lines were randomized to receive trabectedin 1.5 mg/m(2) 24 h (arm A, n = 54) or 1.3 mg/m(2) 3 h (arm B, n = 53). Objective response rate (ORR) per RECIST was the primary efficacy end point. Toxic effects were graded according to the National Cancer Institute-Common Toxicity Criteria v. 2.0. Results: ORR was 38.9% [95% confidence interval (CI) 25.9% to 53.1%; arm A] and 35.8% (95% CI 23.1% to 50.2%; arm B) (intention-to-treat primary analysis). Median time to progression was 6.2 months (95% CI 5.3-8.6 months; arm A) and 6.8 months (95% CI 4.6-7.4 months; arm B). Frequent severe adverse events were nausea/vomiting (24%, arm A; 15%, arm B) and fatigue (15%, arm A; 10%, arm B). Common severe laboratory abnormalities were transient, noncumulative neutropenia (55%, arm A; 37%, arm B) and transaminase increases (alanine aminotransferase, 55%, arm A; 59%, arm B). Conclusions: Both every-3-weeks trabectedin regimes, 1.5 mg/m(2) 24 h and 1.3 mg/m(2) 3 h, were active and reasonably well tolerated in AOC platinum-sensitive patients. Trabectedin every-3-weeks has promising activity and deserves to be further evaluated in relapsed AOC.

  • 10. Nordengren, J
    et al.
    Fredstorp Lidebring, M
    Bendahl, P-O
    Brunner, N
    Fero, M
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Stephens, RW
    Willén, RW
    Casslén, B
    High tumor tissue concentration of plasminogen activator inhibitor-2 (PAI-2) is an independent marker for shorter progression-free survival of patients with early stage endometrial cancer2002In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 97, p. 379-385Article in journal (Refereed)
  • 11. Stuart, G
    et al.
    Åvall-Lundqvist, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    du Bois, A
    Bookman, M
    Bowtell, D
    Brady, M
    Casado, A
    Cervantes, A
    Eisenhauer, E
    Friedlaender, M
    Fujuwara, K
    Grenman, S
    Guastalla, JP
    Harper, P
    Högberg, Thomas
    NSGO (Scandinavia).
    Kaye, S
    Kitchener, H
    Kristensen, G
    Mannel, R
    Meier, W
    Miller, B
    Oza, A
    Ozols, R
    Parmar, M
    Pfisterer, J
    Poveda, A
    Provencher, D
    Pujade-Lauraine, E
    Quinn, M
    Randall, M
    Rochon, J
    Rustin, G
    Sagae, S
    Stehman, F
    Trimble, E
    Thigpen, T
    Vasey, P
    Vergote, I
    Verheijen, R
    Vermorken, J
    Wagner, U
    3rd international ovarian cancer consensus conference: outstanding issues for future consideration2005In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 16, no supplement 8, p. viii36-viii38Article in journal (Refereed)
  • 12. Taube, A
    et al.
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Med P: n som i "programpaket" - om studier av prognostiska faktorer2002In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 99, p. 3302-3305Article in journal (Other academic)
  • 13. Tropé, C
    et al.
    Nordal, R
    Himmelmann, A
    Kjörstad, K
    Onsrud, M
    Simonsen, E
    Högberg, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Einhorn, N
    Pettersson, F
    Frankendal, B
    Pettersson, B
    Tholander, B
    Svanberg, L
    Consolidation treatment of advanced (FIGO stage III) ovarian carcinoma in complete surgical remission after induction chemotherapy: A randomized, controlled, clinical trial comparing whole abdominal radiotherapy, chemotherapy, and no further treatment2003In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 13, p. 278-286Article in journal (Refereed)
  • 14.
    Vermorken, JB
    et al.
    EORTC (Europe).
    Parmar, MKB
    MRC/NCRI (UK).
    Brady, MF
    GOG (USA).
    Eisenhauer, EA
    NCIC-CTG (Canada).
    Högberg, Thomas
    NSGO (Scandinavia).
    Ozols, RF
    GOG (USA).
    Rochon, J
    AGO-OVAR (Germany).
    Rustin, GJS
    MRC/NCRI (UK).
    Sagae, S
    Verheijen, RHM
    EORTC (Europe).
    Clinical trials in ovarian carcinoma: study methodology2005In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 16, no S8, p. 20-29Article in journal (Refereed)
1 - 14 of 14
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