Clinical Abstracts from Overseas

By Stanton R. Mehr
Published: Thursday, Jun 24, 2010

What Do Genes Have to Do With Cancer Survival?

It is well known that genetic phenotype has an effect on cancer incidence, such as breast cancer appearing in members of the same family. Does genetic phenotype also influence survival in cancer? According to researchers from the Karolinska Institute, Stockholm, Sweden, the answer is yes.

The investigators conducted a population-based study of a database of Swedish families, which covered approximately 3 million families. The database included specific information on cancer incidence, treatment, and survival. The database was examined to assess the association of parents and their grown children who were diagnosed with the same cancer. Using Kaplan-Meier survival modeling, offspring’s survival was compared with that of their parents.

The researchers found that grown children who experienced the same cancer as their parent and whose parent had died within 10 years of diagnosis demonstrated shorter survival for at least four common neoplasms compared with parents with longer survival. Specifically, the increased risk of shorter survival for offspring was 75% for breast cancer, 123% for cervical cancer, 107% for colorectal cancer, 107% for prostate cancer and 39% for lung cancer compared with children whose parents survived at least 10 years from diagnosis.

Increased risk of shorter survival in

offspring with same cancer as parent

who experienced short survival.

Cancer Type Relative Risk
Lung 39%
Breast 75%
Prostate 107%
Colorectal 107%
Cervical 123%

The authors conclude that cancer-specific survival in parents may predict same cancer survival in their children. It is an interesting finding in that advances in treatment do not seem to affect these results, or compensate for what might be a less favorable genetic phenotype across many types of cancers. This finding may be of particular importance in choosing treatment approaches (e.g., watchful waiting vs. active treatment in patients with prostate cancer).

Lindström LS, Hall P, Hartman M, et al: Familial concordance in cancer survival: A Swedish population-based Study. Lancet Oncol 2007 Nov;8(11):1001-10016. E-pub 2007 Oct 24.


New Renal Sarcoma Type Characterized

Researchers from Cardiff University, United Kingdom, have reported that they have isolated 20 cases of a previously unidentified kidney sarcoma type.

They sought out unusual anaplastic tumors with varying phenotypical features from a number of registries, including the National Wilms' Tumor Study Pathology Center, the U.K. Children’s Cancer Study Group Trial, and the International Society of Pediatric Oncology. From this evaluation, the investigators grouped 20 cases of a distinct class of renal sarcoma.

These tumors presented most commonly as a large mass (mean diameter, 12.7 cm; weight, 835 g). Cystic components were apparent in the majority of the tumors assessed. All of the tumors demonstrated spindle cells (either with multiple foci or diffuse), anaplastic changes and atypical mitotic figures.

They noted that most of the patients with this tumor type were young (mean age, 12 yr; median, 5 yr), although one patient was 41 years of age. Of these 20 cases, 13 were female patients. The tumors seemed to appear unilaterally, with the right kidney involved in 12 of the 17 evaluable cases.

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